摘要
许多肝性和肝外自身免疫紊乱可能使丙型肝性疾病HCV感染的患者百分比复杂化,不仅仅是感染肝也包括噬淋巴细胞的药物。临床表型的结果可以被分为所谓的HCV症状。后者包括各种以临床上或者血清重叠的风湿性紊乱疾病。因此,在决定治疗方案之前需要正确的患者分类。鉴于病毒感染和免疫学改变的共存,这些情况的管理是相当困难的。在这种情况下,冷球蛋白血管炎代表可通过病原(抗病毒药物)或病理或病状治疗(利妥昔单抗、环磷酰胺、类固醇、血浆置换术)在不同水平进行治疗的HCV相关风湿病的原型。在临床实践中,治疗策略应根据患者的病情考虑特定症状的组合以及疾病的严重度/活动。本综述的重点是一些风湿性疾病的临床诊断评估和治疗方法,使HCV感染复杂化,主要是关节炎、西卡综合征和骨硬化症,而在本论述也陈述了另一篇文章中全面的检测了冷球蛋白血管炎。
关键词: 丙型肝炎病毒,混合型低血球蛋白血症,血管炎,关节炎,Sjögren综合征,骨硬化,淋巴瘤,抗病毒,利妥昔单抗
Current Drug Targets
Title:HCV-Related Rheumatic Manifestations and Therapeutic Strategies
Volume: 18 Issue: 7
关键词: 丙型肝炎病毒,混合型低血球蛋白血症,血管炎,关节炎,Sjögren综合征,骨硬化,淋巴瘤,抗病毒,利妥昔单抗
摘要: 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.
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HCV-Related Rheumatic Manifestations and Therapeutic Strategies, Current Drug Targets 2017; 18 (7) . https://dx.doi.org/10.2174/1389450116666150907103622
DOI https://dx.doi.org/10.2174/1389450116666150907103622 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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