Title:HCV-Related Rheumatic Manifestations and Therapeutic Strategies
Volume: 18
Issue: 7
Author(s): Marco Sebastiani, Dilia Giuggioli, Michele Colaci, Poupak Fallahi, Laura Gragnani, Alessandro Antonelli, Anna Linda Zignego and Clodoveo Ferri*
Affiliation:
- Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio E., Policlinico di Modena, Via del Pozzo, 71, 41100 Modena,Italy
Keywords:
Hepatitis C virus, HCV, mixed cryoglobulinemia, vasculitis, arthritis, Sjögren’s syndrome, ostesclerosis, lymphoma,
antiviral, rituximab.
Abstract: A number of hepatic and extra-hepatic autoimmune disorders may complicate a percentage
of patients with hepatitis C virus (HCV) infection that is both hepatotropic and lymphotropic agent;
the resulting clinical phenotypes can be grouped into the so-called HCV syndrome. This latter includes
various rheumatic disorders that are frequently characterized by clinical or serological overlap;
thus, a correct patients’ classification is necessary prior to decide the therapy.
The management of these conditions is particularly difficult, given the coexistence of viral infection
and immunological alterations. In this scenario, cryoglobulinemic vasculitis represents the prototype
of HCV-related rheumatic disorders that can be treated at different levels by means of etiological (antivirals)
and/or pathogenetic and/or symptomatic treatments (rituximab, cyclophosphamide, steroids,
plasmapheresis, etc). In clinical practice, the therapeutic strategy should take into account the specific
symptoms combination and the severity/activity of the disease, according to each patient’s conditions.
This review focuses on the clinico-diagnostic assessments and therapeutical approaches of some rheumatic
disorders complicating HCV infection, mainly arthritis, sicca syndrome, and osteosclerosis;
while, cryoglobulinemic vasculitis is comprehensively examined in another article of the present issue.
