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Literature analysis of published data on mechanisms of infection, disease progression and treatment of chronic hepatitis C, associated with systemic cryoglobulinemic vasculitis and kidney involvement is presented. A clinical case of effective treatment of cryoglobulinemic vasculitis associated with HCV infection is described. Female with HCV infection genotype 1b with liver fibrosis 1 grade Metavir developed clinical picture of essential mixed cryoglobulinemia II type with monoclonal IgM/kappa production. Cryoglobulinemia was presented with skin hemorrhagic vasculitis, proliferative vasculitis of small liver vessels, kidney involvement with III type membranoproliferative glomerulonephritis. Treatment with Dasabuvir;Оmbitasvir+Paritaprevir+Ritonavir without immunosuppressive medications or steroids resulted in persistent virologic response by 12 weeks after administration and also dramatic reduction of cryoglobulimenia from 27% to 8%, suppression of detectable IgM/kappa production, diminished skin vasculitis, restoration of glomerular filtration rate, proteinuria and decrease in erythrocyteuria.

Background: The current international multicentre open-label, uncontrolled, real-world retrospective study aimed at evaluating the effectiveness and safety of ombitasvir / paritaprevir / ritonavir + dasabuvir - ribavirin (3D therapy) in treatment-naive and treatment-experienced hepatitis C virus (HCV) genotype 1-infected (GT1) patients. Methods: Adult patients with chronic HCV GT1 infection, scheduled for 3D therapy according to therapeutic guidelines, were eligible. Demographicandclinical datawerecollected retrospectively by reviewing individuals health records. The primary effectiveness endpoint was the sustained virological response at 12 weeks following the end of treatment (SVR12). Results: The participants in the current study consisted of 134 patients with HCV GT1 infection, including 10 liver transplant recipients. SVR12 was achieved in 120 (96.8%) non-transplant and all liver transplant patients (100%). Significant improvement in liver function tests were observed. Among 4 treatment failures, 2 patients were non-responders and 2 patients relapsed. OBV/PTV/r + DSV - RBV regimen was well tolerated in most patients with treatment discontinuation due to adverse events in 3 patients. The most frequent adverse events were asthenia (25.8%), fatigue (16.1%), skin pruritus (12.9%), and dyspepsia (11.3%). Conclusions: The current real-life study demonstrated the effectiveness and safety of OBV/PTV/r + DSV-RBV in patients with HCV GT1, including patients with cirrhosis, a liver transplant recipient and the one who failed previous antiviral therapies. [ABSTRACT FROM AUTHOR]