Tratamiento de la vasculitis crioglobulinémica asociada al virus de la hepatitis C

Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and redissolve on rewarming. These immunoglobulins can form immune complexes that precipitate in blood vessels, activate complement and cause cryoglobulinemic vasculitis. Cryoglobulinemia is classified intro three serological subsets; of these, type II, or mixed cryoglobulinemia, is associated with hepatitis C virus (HCV) infection in more than 80% of cases. The discovery of this association has changed therapeutic strategies in cryoglobulinemic vasculitis, which is now considered an extrahepatic manifestation of HCV infection. Therefore, the main therapeutic approach currently consists of antiviral therapies such as interferon or ribavirin. In patients refractory to these treatments, new agents such as rituximab, infliximab and mycophenolate mofetil are being used. The development of an effective vaccine against HCV would drastically reduce the number of cases of this form of vasculitis.