{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:07:30Z","timestamp":1787771250281,"version":"build-2784847793"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Direct\u2010acting antivirals (DAAs) usually lead to improvement\/remission of cryoglobulinemic vasculitis (CV), although symptoms may persist\/recur after a sustained virological response (SVR). We evaluated hematological and genetic markers in patients with HCV\u2010SVR vasculitis with and without persisting\/recurring symptoms to early predict the CV outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Ninety\u2010eight patients with HCV\u2010CV were prospectively enrolled after a DAA\u2010induced SVR: Group A: 52 with complete clinical response; Group B: 46 with symptom maintenance\/recurrence. Monoclonal B\u2010cell lymphocytosis, t(14;18) translocation, and abnormal free light chains \u03ba\/\u03bb ratios were detected by flow cytometry or nested\u2010PCR or nephelometry in 4% Group A versus 17% Group B (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.04) patients, 17% Group A versus 40% Group B patients (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02), and 17% Group A versus 47% Group B (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.003) patients, respectively. At least 1 out of 3 clonality markers was altered\/positive in 29% of Group A versus 70% of Group B patients (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). When available, pretherapy samples were also tested for t(14;18) translocation (detected in 12\/37 [32%] Group A and 21\/38 [55%] Group B) and \u03ba\/\u03bb ratios (abnormal in 5\/35 [14%] Group A and 20\/38 [53%] Group B) (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0006), whereas at least one clonality marker was detected\/altered in 16\/37 (43%) Group A and 30\/38 (79%) Group B (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.002). CV\u2010associated single\u2010nucleotide polymorphisms were tested by real\u2010time PCR. Among them, notch4 rs2071286 T minor allele and TT genotype showed a higher frequency in Group B versus Group A (46% vs. 29%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01, and 17% vs. 2%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.006, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Hematological or genetic analyses could be used to foresee the CV clinical response after DAA therapy and could be valuable to assess a rational flowchart to manage CV during follow\u2010up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31804","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T13:05:43Z","timestamp":1615813543000},"page":"1164-1173","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Hematological and Genetic Markers in the Rational Approach to Patients With HCV Sustained Virological Response With or Without Persisting Cryoglobulinemic Vasculitis"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-9149","authenticated-orcid":false,"given":"Laura","family":"Gragnani","sequence":"first","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Lorini","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Marri","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Basile","sequence":"additional","affiliation":[{"name":"Area Diagnostica di Laboratorio,Fondazione Policlinico Universitario \u201cA. Gemelli\u201d, I.R.C.C.S. Rome,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Santarlasci","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"},{"name":"Flow Cytometry Diagnostic Center and Immunotherapy (CDCI),Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Monti","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Madia","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Petraccia","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Stasi","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Marello","sequence":"additional","affiliation":[{"name":"MaSVE Interdepartmental Hepatology Center,Department of Experimental and clinical Medicine,University of Florence,Center for Research and Innovation CRIA\u2010MaSVE,AOU Careggi,Florence,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Napodano","sequence":"additional","affiliation":[{"name":"Dipartimento di scienze Mediche e Chirurgiche,UOC Gastroenterologia Fondazione Policlinico Universitario \u201cA. 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