Hepatitis C treatment benefits lupus patients

the Clinical Advisor take:

Immunosuppressive therapy is not associated with hepatitis C virus (HCV) reactivation in patients with systemic lupus erythematosus (SLE) who are positive for antibodies to HCV (anti-HCV), according to a study published in Lupus.

These patients generally have a high risk for hepatitis flares, but this study suggests that HCV infection has minimal impact on SLE’s clinical appearance.

Immunosuppressive agents used to treat SLE have been thought to increase the likelihood of hepatitis flares in anti-HCV-positive patients. The researchers in this study wanted to determine if these immunosuppressive agents definitively increase the risk for hepatitis flares.

The study included 158 patients with diagnosed SLE who also had anti-HCV status available. The researchers used the SLE disease activity index (SLEDAI) to monitor the participants. They also recorded any hepatitis flares, kept track of the use of immunosuppressive agents, performed biochemical liver function and immunologic tests, and evaluated virological response to interferon plus ribavirin treatment by HCV viral load.

In total, 16.5% of the participants were anti-HCV-positive (n=26), and 83.5% were anti-HCV-negative (n=132).

After a mean follow-up period of 8.4 years, 10 of the anti-HCV-positive participants experienced HCV reactivation. The researchers compared these participants to the 16 anti-HCV-positive participants who did not experienced HCV, and they found no significant difference between use of immunosuppressive agents.

After treating eight of the 10 patients with hepatitis flares, 75% achieved a sustained virological response after 24 weeks of treatment.