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Urraro T, Gragnani L, Piluso A, et al. Combined treatment with antiviral therapy and rituximab in patients with mixed cryoglobulinemia: review of the literature and report of a case using direct antiviral agents-based antihepatitis C virus therapy. Case Reports Immunol. 2015;2015:816424doi: 10.1155/2015/816424.
Urraro, T., Gragnani, L., Piluso, A., Fabbrizzi, A., Monti, M., Fognani, E., Boldrini, B., Ranieri, J., & Zignego, A. L. (2015). Combined treatment with antiviral therapy and rituximab in patients with mixed cryoglobulinemia: review of the literature and report of a case using direct antiviral agents-based antihepatitis C virus therapy. Case reports in immunology, 2015816424. https://doi.org/10.1155/2015/816424
Urraro, Teresa, et al. "Combined treatment with antiviral therapy and rituximab in patients with mixed cryoglobulinemia: review of the literature and report of a case using direct antiviral agents-based antihepatitis C virus therapy." Case reports in immunology vol. 2015 (2015): 816424. doi: https://doi.org/10.1155/2015/816424
Urraro T, Gragnani L, Piluso A, Fabbrizzi A, Monti M, Fognani E, Boldrini B, Ranieri J, Zignego AL. Combined treatment with antiviral therapy and rituximab in patients with mixed cryoglobulinemia: review of the literature and report of a case using direct antiviral agents-based antihepatitis C virus therapy. Case Reports Immunol. 2015;2015:816424. doi: 10.1155/2015/816424. Epub 2015 Mar 01. PMID: 25815218; PMCID: PMC4359800.
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Case Reports Immunol. 2015;2015:816424. doi: 10.1155/2015/816424. Epub 2015 Mar 01.

Combined treatment with antiviral therapy and rituximab in patients with mixed cryoglobulinemia: review of the literature and report of a case using direct antiviral agents-based antihepatitis C virus therapy.

Case reports in immunology

Teresa Urraro, Laura Gragnani, Alessia Piluso, Alessio Fabbrizzi, Monica Monti, Elisa Fognani, Barbara Boldrini, Jessica Ranieri, Anna Linda Zignego

Affiliations

  1. Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Lagro Brambilla 3, 50134 Florence, Italy.

PMID: 25815218 PMCID: PMC4359800 DOI: 10.1155/2015/816424

Abstract

Mixed cryoglobulinemia (MC) is an autoimmune/B-cell lymphoproliferative disorder associated with Hepatitis C Virus (HCV) infection, manifesting as a systemic vasculitis. In the last decade, antiviral treatment (AT) with pegylated interferon (Peg-IFN) plus ribavirin (RBV) was considered the first therapeutic option for HCV-MC. In MC patients ineligible or not responsive to antivirals, the anti-CD20 monoclonal antibody rituximab (RTX) is effective. A combined AT plus RTX was also suggested. Since the introduction of direct acting antivirals (DAAs), few data were published about MC and no data about a combined schedule. Here, we report a complete remission of MC after a sustained virological response following a combined RTX/Peg-IFN+RBV+DAA (boceprevir) treatment and review the literature about the combined RTX/AT.

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