J Rheumatol 1998 Jun;25(6):1115-1117

Ribavirin in Hepatitis C related cryoglobulinemia.

Durand JM, Cacoub P, Lunel-Fabiani F, Cosserat J, Cretel E, Kaplanski G, Frances C, Bletry O, Soubeyrand J, Godeau P

Department of Internal Medicine, CHU Sainte Marguerite, Marseille, France.

OBJECTIVE:

An open, uncontrolled trial of ribavirin, an oral guanosine nucleoside analog for treatment of Hepatitis C, in patients with Hepatitis C virus (HCV) associated cryoglobulinemia intolerant to interferon.

METHODS:

Five patients with cryoglobulinemia related to HCV infection unresponsive to interferon therapy received oral ribavirin (100 to 1200 mg daily) for 10 to 36 months.

RESULTS:

Patients treated with ribavirin had prompt decrease in serum aminotransferase levels and marked improvement of manifestations of cryoglobulinemia within a few weeks. Ribavirin did not eradicate HCV RNA from the sera, but a decrease in viral load was observed in 3 patients, from 232 to 86 x 10(5) copies HCV/ml. Relapse occurred within 3 months once therapy was discontinued. The drug was well tolerated, but mild dose related hemolysis was common.

CONCLUSION:

Ribavirin monotherapy may be effective in patients with symptomatic cryoglobulinemia related to HCV infection, but this effect is not sustained when ribavirin therapy is discontinued.

PMID: 9632073, UI: 98293834