Direct Antiviral Agents for Hepatitis C–Associated Mixed Cryoglobulinemia

Although hepatitis C (HCV)–associated mixed cryoglobulinemia (MCS) is a rare complication of HCV infection, it can result in small-to-medium vessel vasculitis and glomerulonephritis. A few studies have suggested that 48 weeks of interferon and ribavirin with or without boceprevir or telaprevir is effective. However, the use of interferon with or without a first-generation protease inhibitor in this population has been hampered by substantial adverse effects and limited efficacy.

Now, investigators have conducted a retrospective case series to evaluate the efficacy and safety of interferon-free, sofosbuvir-based, direct antiviral agents in 12 patients with HCV-associated MCS, including 7 with renal involvement. Patients had HCV RNA levels >10…