Hepatitis B Virus-Related Cryoglobulinemic Vasculitis: Review of the Literature and Long-Term Follow-Up Analysis of 18 Patients Treated with Nucleos

Hepatitis B virus (HBV) chronic infection causes progressive liver damage, although about 20% of patients develop extrahepatic manifestations such as cryoglobulinemic vasculitis (CV). Clinical manifestations range from mild to moderate (purpura, asthenia, arthralgia) to severe (leg ulcers, periphera...

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Bibliographic Details
Published in:Viruses 2021-05, Vol.13 (6)
Main Authors: Mazzaro, Cesare, Dal Maso, Luigino, Gragnani, Laura, Visentini, Marcella, Saccardo, Francesco, Filippini, Davide, Andreone, Pietro, Zignego, Anna Linda, Gattei, Valter, Monti, Giuseppe, Galli, Massimo, Quartuccio, Luca
Format: Article
Language:English
Subjects:
Causes of
Complications and side effects
Drug therapy
Hepatitis B
Nucleoside analogs
Patient outcomes
Vasculitis
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Summary:Hepatitis B virus (HBV) chronic infection causes progressive liver damage, although about 20% of patients develop extrahepatic manifestations such as cryoglobulinemic vasculitis (CV). Clinical manifestations range from mild to moderate (purpura, asthenia, arthralgia) to severe (leg ulcers, peripheral neuropathy, glomerulonephritis, non-Hodgkin lymphoma). A comprehensive review of therapeutic options for HBV-related CV is lacking. Nucleos(t)ide analogues (NA) suppress HBV replication in 90–100% of cases and induce clinical response in most patients with mild-to-moderate CV. Plasma exchange can be performed in patients with severe CV and should be considered in severe or life-threatening cases combined with high doses of corticosteroids and antiviral treatment. A cautious use of rituximab can be considered only in association with NA treatment in refractory cases. A review of the literature and an analysis of data collected by six centers of the Italian Group for the Study of Cryoglobulinemia on 18 HBV-CV nucleotide/nucleoside analogues (NAs)-treated patients were carried out.
ISSN:1999-4915
1999-4915
DOI:10.3390/v13061032