Persistence of mixed cryoglobulinemia after virologically successful therapy of chronic hepatitis C: results of a two-year study

We aimed to study the frequency of chronic hepatitis C-associated mixed cryoglobulinemia after antiviral therapy (AVT) with directacting antivirals (DAA) in patients with sustained virologic response along 2 years. Clinical cohort included 43 patients with chronic hepatitis C and symptomatic mixed cryoglobulinemia who underwent virologically effective AVT with DAA in various regimens. Patients were examined for the presence of cryoglobulinemia by visual semi-quantitative method at the beginning of the AVT, at the end of the therapy, 12, 24, 48, 96 weeks after the end of the therapy. At the end of the AVT, cryoglobulins persisted in 56% of cases, 12 weeks after the end of the AVT — in 49%, after 24 weeks — in 44%, after 48 weeks — in 37%, after 96 weeks — in 23%. The frequency of detection of cryoglobulins at each point of the examination was the highest in patients with initially high cryocrit (≥10%). The initial levels of cryocrite (at the beginning of the AVT) had significant correlation with the subsequent presence of cryoglobulins at all points of the examination. In some patients with virologically effective AVT with DAA, cryoglobulinemia was detected up to 96 weeks of follow-up, which requires special approaches to the management of this category of patients.

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