{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:51:23Z","timestamp":1785898283210,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T00:00:00Z","timestamp":1530144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005010","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["17391"],"award-info":[{"award-number":["17391"]}],"id":[{"id":"10.13039\/501100005010","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003980","name":"Istituto Toscano Tumori","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003980","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003056","name":"Ente Cassa di Risparmio di Firenze","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,8]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Cryoglobulinaemic vasculitis (CV) is a lymphoproliferative disorder related to hepatitis C virus (HCV<\/jats:styled-content>) infection; anti\u2010viral therapy is the first therapeutic option. CV<\/jats:styled-content> can be incapacitating, compromising the patients\u2019 quality of life (QoL). In a controlled study, interferon\u2010based therapy was associated with a lower virological response in vasculitic patients than in patients without vasculitis. Limited, uncontrolled data on direct\u2010acting anti\u2010virals are available.<\/jats:p><\/jats:sec>Aim<\/jats:title>To evaluate safety, clinical efficacy, virological response and the impact of interferon\u2010free treatment on QoL in HCV patients with and without mixed cryoglobulinaemia (MC).<\/jats:p><\/jats:sec>Methods<\/jats:title>We prospectively studied HCV<\/jats:styled-content> patients with cryoglobulinaemia (with vasculitis\u2010CV\u2010 and without vasculitis\u2010MC<\/jats:styled-content>\u2010) and without cryoglobulinaemia (controls), treated with direct\u2010acting anti\u2010virals. Hepato\u2010virological parameters, CV<\/jats:styled-content> clinical response and impact on QoL were assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>One hundred and eighty\u2010two HCV<\/jats:styled-content> patients were recruited (85 with CV<\/jats:styled-content>, 54 with MC<\/jats:styled-content> and 43 controls). A sustained virological response at 12 weeks (SVR<\/jats:styled-content>12) was achieved in 166 (91.2%) patients (77\/85 CV<\/jats:styled-content>, 48\/54 MC<\/jats:styled-content>, 41\/43 controls). In CV SVR<\/jats:styled-content> patients, cryocrit levels progressively decreased and clinical response progressively improved, reaching 96.7%, 24 weeks after treatment. QoL, baseline physical and mental component summaries were lower in the CV<\/jats:styled-content> group compared to the other groups (P<\/jats:italic> < 0.05). Scores improved in all groups, and significantly in CV<\/jats:styled-content> patients after SVR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>No significant differences in SVR<\/jats:styled-content> rates were recorded between cryoglobulinaemic patients and controls and a high clinical and immunological efficacy was confirmed in CV<\/jats:styled-content>, supporting the role of interferon\u2010free therapy as the first therapeutic option. Interestingly, CV<\/jats:styled-content> patients had worse baseline QoL than other HCV<\/jats:styled-content>\u2010positive groups and interferon\u2010free therapy was effective in significantly increasing QoL, suggesting the important role of direct\u2010acting anti\u2010viral\u2010based therapy in improving CV<\/jats:styled-content>'s individual and social burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14845","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T07:29:24Z","timestamp":1530170964000},"page":"440-450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Interferon\u2010free therapy in hepatitis C virus mixed cryoglobulinaemia: a prospective, controlled, clinical and quality of life analysis"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-9149","authenticated-orcid":false,"given":"L.","family":"Gragnani","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Cerretelli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lorini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Steidl","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Giovannelli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence 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Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Urraro","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Caini","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine and Department of Oncology Interdepartmental Center for Systemic Manifestations of Hepatitis Viruses (MASVE) Azienda Ospedaliero\u2010Universitaria Careggi (AOUC) Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Xheka","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine 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