title: Treatment of extrahepatic manifestations of chronic hepatitis C viral infection--a challenge.
abstract: Often, chronic hepatitis C infection is clinically manifested as extra hepatic disease. Therapy of the extra hepatic manifestations (EHM) is always difficult and based on the optimal and individual association of antiviral treatment, immunosuppressant and plasma cleaning techniques. We observed for 4 years 246 patients admitted to "Colentina" Internal Medicine Clinic, of whom 168 were diagnosed as chronic C hepatitis. 130 of those patients have had at least one EHM. In our experience, the presence of an EHM is significantly correlated with lack of early viral response and sustained viral response, as well. Cryoglobulinemic vasculitis needs to be treated with oral or pulse corticotherapy associated to plasmapheresis. When present, peripheral neuropathy and cryocrit greater than 10% are indicators of need of more than 3 plasmapheresis sessions.
authors.affiliation: Clinic of Internal Medicine, "Colentina" Hospital, "C. Davila" University of Medicine, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Tănăsescu
authors.forename: R
authors.initials: R
authors.lastname: Ionescu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D010956:Plasmapheresis
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids