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Cryoglobulinaemia vasculitis in patients coinfected with HIV and hepatitis C virus

David Saadoun1, Laurent Aaron, Mathieu Resche-Rigon

  • 1Service de Médecine Interne, Hôpital La Pitié-Salpêtrière, Paris, France.

AIDS (London, England)
|March 22, 2006
PubMed

Insights

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection can cause mixed cryoglobulinemia (MC) vasculitis. Anti-HCV therapy showed a beneficial effect in these patients.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Rheumatology

Background:

  • Mixed cryoglobulinemia (MC) vasculitis is a rare condition often associated with hepatitis C virus (HCV) infection.
  • The interplay between HCV and human immunodeficiency virus (HIV) coinfection in the context of MC vasculitis requires further elucidation.

Purpose of the Study:

  • To characterize mixed cryoglobulinemia (MC) vasculitis in patients coinfected with HCV and HIV.
  • To compare the clinical features and outcomes of MC vasculitis in HIV/HCV-coinfected patients versus HCV-monoinfected patients.

Main Methods:

  • A retrospective multicenter study was conducted using the GERMIVIC Database, analyzing 4005 HIV/HCV-coinfected patients.
  • The characteristics and outcomes of 11 HIV/HCV-coinfected patients with MC vasculitis were compared to 118 HCV-monoinfected patients with MC vasculitis.

Main Results:

  • HIV/HCV-coinfected patients with MC vasculitis were younger, more frequently male, and had a history of intravenous drug use compared to HCV-monoinfected patients.
  • Common clinical manifestations included polyneuropathy, purpura, arthralgia, and kidney involvement. Anti-HCV therapy (interferon-alfa and ribavirin) demonstrated a beneficial effect, leading to sustained virological response and clinical improvement in some patients.
  • Antiretroviral therapy did not significantly improve MC vasculitis, irrespective of HIV virological response.

Conclusions:

  • Anti-HCV therapy offers a beneficial treatment strategy for patients coinfected with HIV and HCV presenting with MC vasculitis.
  • Understanding the specific characteristics of MC vasculitis in the context of HIV/HCV coinfection is crucial for effective management.
Abstract

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