Combined Treatment with Antiviral Therapy and Rituximab in Patients with Mixed Cryoglobulinemia: Review of the Literature and Report of a Case Using Direct Antiviral Agents-Based Antihepatitis C Virus Therapy

Table 1

Main clinical and laboratory data before rituximab (RTX-baseline), 2 months after rituximab cycle (BOC-baseline), and at the end of follow-up after boceprevir-based antiviral therapy (post-BOC).

	RTX-baseline; (June 2011)	BOC-baseline; (September 2011)	Post-BOC; (November 2013)
Gender	Female
Age (years)	63
IL28b rs12979860	T/T
Stiffness (kPa)	14.5	12	11.7
HCV titer (IU × 10^6/mL)	0.98	1.39	NEG
ALT (IU/L)^†	44	37	19
MC manifestations
Clinical
Purpura	++	−	−
Arthralgia	++	+	−
Weakness	++	−	−
Peripheral neuropathy	−	−	−
Raynaud syndrome	−	−	−
Nephritis	−	−	−
Sicca syndrome	++	+	+
Laboratory
Cryocrit (%)	5	0	0
RF (IU/mL)	24	<10	<10
C4 (mg/dL)^‡	9	16	25

RTX: rituximab; BOC: boceprevir; MC: mixed cryoglobulinemia; IL28B: polymorphism of interleukin-28B; stiffness: liver stiffness as evaluated by transient elastography; kPa: kilopascal; IU: international units; ALT: alanine aminotransferase; RF: rheumatoid factor. ^†Normal values: <40 IU/L; normal values: <10 IU/mL; ^‡normal values: from 10 to 40 mg/dL.