Abstract
The case of chronic hepatitis C 1b genotype with grade 3 fibrosis according to Metavir, complicated by the development of mixed type III cryoglobulinemia, cryoglobulinemic vasculitis with damage to the skin vessels of the skin (hemorrhagic vasculitis), and the liver (alternatively proliferative vasculitis) is demonstrated. The introduction of daclatasvir + asunaprevir was virologically unsuccessful: mutations D168E and L31V were detected against the background of a virological breakthrough. A repeated course of antiviral therapy with the combination of Grazoprevir + Elbasvir in combination with sofosbuvir led to a stable virologic response, partial immunological and clinical remission.
Highlights
The case of chronic hepatitis C 1b genotype with grade 3 fibrosis according to Metavir
L31V were detected against the background of a virological breakthrough
Elbasvir in combination with sofosbuvir led to a stable virologic response
Summary
The case of chronic hepatitis C 1b genotype with grade 3 fibrosis according to Metavir, complicated by the development of mixed type III cryoglobulinemia, cryoglobulinemic vasculitis with damage to the skin vessels of the skin (hemorrhagic vasculitis), and the liver (alternatively proliferative vasculitis) is demonstrated. На 20-й неделе зафиксированы вирусологический прорыв (выявлена РНК ВГС в плазме крови в количестве 11235 МЕ/мл), рост криокрита и повышение активности ревматоидного фактора. В представленном случае срок инфицирования ВГС установить не удалось, заболевание было выявлено при обследовании по поводу появления внепечёночной манифестации ВГС – артралгий.
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