What is the treatment of choice for HCV-related polyarteritis nodosa (PAN)?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Given that the existence of this entity has been controversial, limited data exist to support appropriate treatment. In a French cohort of 161 patients with HCV-associated vasculitis, 31 patients were diagnosed with PAN. Over half the patients were treated with antiviral therapy and nearly half received corticosteroids. Other treatments included rituximab (22.6%), plasmapheresis (35.5%), and immunosuppression with cyclophosphamide or azathioprine (16.1%). [55] More patients with HCV-related PAN achieved clinical remission in this group than those with HCV-associated mixed cryoglobulinemia (79.3% vs 57.5%). Remission was closely correlated with successful HCV clearance. A higher frequency of relapse was seen in the HCV-related PAN patients than in HCV-associated mixed cryoglobulinemia patients (18% at 1 year vs 45% at 1 year).


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