Digestive Diseases and Sciences

, Volume 59, Issue 8, pp 2007–2012 | Cite as

Membranoproliferative Glomerulonephritis, Type II Cryoglobulinemia and Triple Therapy for Hepatitis C: A Case Series and Review of the Literature

  • Kevin Humphries
  • Jama M. Darling
  • A. Sidney BarrittIV
Case Report


Hepatitis C Triple therapy Boceprevir Telaprevir Cryoglobulinemia Membranoproliferative glomerulonephritis 



This work was supported, in part, by the National Institutes of Health, 1KL2-RR025746-03 and UL1-RR025747.

Conflict of interest



  1. 1.
    Cacoub P, Lidove O, Maisonobe T, et al. Interferon-alpha and ribavirin treatment in patients with hepatitis C virus-related systemic vasculitis. Arthritis Rheum. 2002;46:3317–3326.PubMedCrossRefGoogle Scholar
  2. 2.
    Cacoub P, Saadoun D, Limal N, Sene D, Lidove O, Piette J-C. PEGylated interferon alfa-2b and ribavirin treatment in patients with hepatitis C virus-related systemic vasculitis. Arthritis Rheum. 2005;52:911–915.Google Scholar
  3. 3.
    Saadoun D, Resche-Rigon M, Thibault V, Piette J-C, Cacoub P. Antiviral therapy for hepatitis C virus–associated mixed cryoglobulinemia vasculitis: a long-term followup study. Arthritis Rheum. 2006;54:3696–3706.Google Scholar
  4. 4.
    Saadoun D, Delluc A, Piette JC, Cacoub P. Treatment of hepatitis C-associated mixed cryoglobulinemia vasculitis. Curr Opin Rheumatol. 2008;20:23–28.Google Scholar
  5. 5.
    Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS, et al. Boceprevir for untreated chronic HCV genotype 1 infection. N Engl J Med. 2011;364:1195–1206.Google Scholar
  6. 6.
    Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S, et al. Boceprevir for previously treated chronic HCV genotype 1 infection. N Engl J Med. 2011;364:1207–1217.Google Scholar
  7. 7.
    Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH, et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med. 2011;364:2405–2416.Google Scholar
  8. 8.
    Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S, et al. Telaprevir for retreatment of HCV infection. N Engl J Med. 2011;364:2417–2428.Google Scholar
  9. 9.
    Sherman KE, Flamm SL, Afdhal NH, Nelson DR, Sulkowski MS, Everson GT, et al. Response-guided telaprevir combination treatment for hepatitis C virus infection. N Engl J Med. 2011;365:1014–1024.Google Scholar
  10. 10.
    Donada C, Crucitti A, Donadon V, Tommasi L, Zanette G, Crovatto M, et al. Systemic manifestations and liver disease in patients with chronic hepatitis C and type II or III mixed cryoglobulinaemia. J Viral Hepat. 1998;5:179–185.Google Scholar
  11. 11.
    Nagasaka A, Takahashi T, Sasaki T, Takimoto K, Miyashita K, Nakamura M, et al. Cryoglobulinemia in Japanese patients with chronic hepatitis C virus infection: host genetic and virological study. J Med Virol. 2001;65:52–57.Google Scholar
  12. 12.
    Saadoun D, Landau DA, Calabrese LH, Cacoub PP. Hepatitis C-associated mixed cryoglobulinaemia: a crossroad between autoimmunity and lymphoproliferation. Rheumatology (Oxford). 2007;46:1234–1242.Google Scholar
  13. 13.
    Charles ED, Dustin LB. Hepatitis C virus-induced cryoglobulinemia. Kidney Int. 2009;76:818–824.Google Scholar
  14. 14.
    Ferri C, Sebastiani M, Giuggioli D, Cazzato M, Longombardo G, Antonelli A, et al. Mixed cryoglobulinemia: demographic, clinical, and serologic features and survival in 231 patients. Semin Arthritis Rheum. 2004;33:355–374.Google Scholar
  15. 15.
    Saadoun D, Resche-Rigon M, Sene D, Perard L, Karras A, Cacoub P. Rituximab combined with Peg-interferon-ribavirin in refractory hepatitis C virus-associated cryoglobulinaemia vasculitis. Ann Rheum Dis. 2008;67:1431–1436.Google Scholar
  16. 16.
    Cacoub P, Terrier B, Saadoun D. Hepatitis C virus-induced vasculitis: therapeutic options. Ann Rheum Dis. 2014;73:24–30.Google Scholar
  17. 17.
    Lake JR. The role of immunosuppression in recurrence of hepatitis C. Liver Transpl. 2003;9:S63–S66.Google Scholar
  18. 18.
    Jacobson IM, Pawlotsky J-M, Afdhal NH, Dusheiko GM, Forns X, Jensen DM, et al. A practical guide for the use of boceprevir and telaprevir for the treatment of hepatitis C. J Viral Hepat. 2012;19:1–26.Google Scholar
  19. 19.
    Pietrogrande M, De Vita S, Zignego AL, Pioltelli P, Sansonno D, Sollima S, et al. Recommendations for the management of mixed cryoglobulinemia syndrome in hepatitis C virus-infected patients. Autoimmun Rev. 2011;10:444–454.Google Scholar
  20. 20.
    Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247–254.Google Scholar
  21. 21.
    Saadoun D, Resche Rigon M, Thibault V, Longuet M, Pol S, Blanc F, et al. Peg-IFNα/ribavirin/protease inhibitor combination in hepatitis C virus associated mixed cryoglobulinemia vasculitis: results at week 24. Ann Rheum Dis. 2013 Apr 20.Google Scholar
  22. 22.
    Mauss S, Hueppe D, Alshuth U. Renal impairment is frequent in chronic hepatitis C patients under triple therapy with telaprevir or boceprevir. Hepatology. 2014;59:46–48.Google Scholar
  23. 23.
    Iannuzzella F, Vaglio A, Garini G. Management of hepatitis C virus-related mixed cryoglobulinemia. Am J Med. 2010;123:400–408.Google Scholar
  24. 24.
    Saadoun D, Resche Rigon M, Sene D, Terrier B, Karras A, Perard L, et al. Rituximab plus Peg-interferon-alpha/ribavirin compared with Peg-interferon-alpha/ribavirin in hepatitis C-related mixed cryoglobulinemia. Blood. 2010;116:326–334; quiz 504–505.Google Scholar
  25. 25.
    Latt N, Alachkar N, Gurakar A. Hepatitis C virus and its renal manifestations: a review and update. Gastroenterol Hepatol (NY). 2012;8:434–445.Google Scholar
  26. 26.
    Landau D-A, Saadoun D, Halfon P, Martinot-Peignoux M, Marcellin P, Fois E, et al. Relapse of hepatitis C virus-associated mixed cryoglobulinemia vasculitis in patients with sustained viral response. Arthritis Rheum. 2008;58:604–611.Google Scholar
  27. 27.
    Barritt AS, Fried MW. Maximizing opportunities and avoiding mistakes in triple therapy for hepatitis C virus. Gastroenterology. 2012;142:1314–1323.e1.Google Scholar
  28. 28.
    Poordad F, Sulkowski M, Reddy R, Di Bisceglie AM, Zeuzem S, Afdhal N, et al. Anemia had no effect on efficacy outcomes in treatment-naïve patients who received telaprevir-based regimen in the advance and illuminate phase 3 studies. Gastroenterology. 2011;140:S898-899.Google Scholar
  29. 29.
    Roberts S, Andreone P, Pol S, et al. Impact of anemia and ribavirin dose reduction on SVR to a telaprevir-based regiment in patients with HCV genotype 1 and prior peginterferon/ribavirin treatment failure in the phase II REALIZE study. Hepatology. 2011;1007A–1008A.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Kevin Humphries
    • 1
  • Jama M. Darling
    • 2
  • A. Sidney BarrittIV
    • 2
  1. 1.Department of MedicineUniversity of North CarolinaChapel HillUSA
  2. 2.Division of Gastroenterology and Hepatology, Department of MedicineUniversity of North CarolinaChapel HillUSA

Personalised recommendations