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Post Info TOPIC: Harvoni SVR and then case of psoriasis remission
Canuck


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Harvoni SVR and then case of psoriasis remission
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Further to original post-

 

I cannot access "fuller" info on this case, other than a few extra details, such as below: an article pre-amble describing psoriasis, and, other references to this 80 year old patients psoriatic lesions being marked, and that despite ongoing attempts with various combined treatment methods, including differing potent steroidal psoriatic meds, his psoriasis was described as persisting and "unmanageable" in this nine year period (prior to HCV treatment commencement), and miscellaneous such as that the patients pre-treatment HCV VL was "6.5 log10 IU/ml" - over 3 million. Of interest to me was the gradual but overall marked psoriatic improvement that was noted from the onset of the HCV DAA SOT.

 

.. Psoriasis is a chronic, immune-mediated skin disorder that is associated with increased systemic inflammation and overproduction of inflammatory cytokines. The relationship between HCV infection and psoriasis is uncertain, but presence of HCV could change the expression of inflammatory cytokines and alter how psoriasis is expressed in susceptible patients ...

 

Also: From the Annals of Internal Medicine - another excerpt of the letter by  - Masaru Enomoto, MD; Chiharu Tateishi, MD; Daisuke Tsuruta, MD; Akihiro Tamori, MD; Norifumi Kawada, MD

...  Background: Hepatitis C virus (HCV) infection is a systemic disease with extrahepatic manifestations that include skin involvement, such as mixed cryoglobulinemia, lichen planus, and porphyria cutanea tarda (1). Some studies also suggest an association between HCV infection and psoriasis (2). 

Objective: To provide additional information about the possible association between HCV infection and psoriasis.

Case Report: In September 2015, an 80-year-old man with a 9-year history of refractory psoriasis was referred to us. The patient had small, well-demarcated, pruritic, scaly erythema on the trunk and upper and lower extremities with a Psoriasis Area and Severity Index score of 8.3 (Figure 1, left). We continued topical therapy with the corticosteroid clobetasol and the vitamin D3 analogue maxacalcitol and added narrowband ultraviolet B phototherapy, 0.5 J/cm2 weekly (Figure 2). The patient's symptoms and signs persisted even after topical therapy was replaced with betamethasone and the vitamin D3 analogue calcipotriol ...



-- Edited by Canuck on Monday 22nd of January 2018 05:56:46 AM

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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

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Canuck


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I thought so.

Interesting all round!

Just nice to see an 80 year old getting treated with the new DAA's alone! (Just the "finding" of his HCV condition of "unknown duration" was good!) And super bonus about the psoriasis remission as well.

We need docs to publish more of their findings. Ongoing feedback/data (on all things HCV) is good learning, and important (I think).

Would like to have had a bit more of the details on this story ... if I can find anything, I'll post it. smile C.



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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Tig


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Now that is an excellent article! HCV impacts so many areas and here’s another example of the benefits of successful treatment. That really is good news!



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Canuck


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Published in Gastroenterology - News · January 18, 2018

Psoriasis Remission Described After Hepatitis C Virus Treatment

Case report: After initiation of ledipasvir-sofosbuvir, HCV RNA decreased, and skin lesions improved

HealthDay

 

WEDNESDAY, Jan. 17, 2018 (HealthDay News) -- A case of remission of psoriasis after treatment of chronic hepatitis C virus (HCV) has been described in a research letter published online Jan. 16 in the Annals of Internal Medicine.

Masaru Enomoto, M.D., from Osaka City University in Japan, and colleagues present the case of an 80-year-old man with a nine-year history of refractory psoriasis, with a Psoriasis Area and Severity Index score of 8.3. The patient was treated with topical therapy with the corticosteroid clobetasol and the vitamin D3analogue maxacalcitol; narrowband ultraviolet B phototherapy was added. Even after topical therapy was replaced with betamethasone and the vitamin D3analogue calcipotriol, the patient's symptoms and signs persisted.

The researchers found that the patient had chronic HCV genotype 1b infection of unknown duration, and had not been treated for HCV infection. A 12-week course of ledipasvir-sofosbuvir was initiated. After initiation of ledipasvir-sofosbuvir therapy, the HCV RNA level decreased rapidly, became undetectable on polymerase chain reaction testing by week four, and remained undetectable for 24 weeks after completion of therapy. The skin lesions started to resolve gradually soon after initiation of ledipasvir-sofosbuvir therapy. The dose of topical agents and frequency of phototherapy were reduced and the Psoriasis Area and Severity Index score decreased to 2.0.

"Here, we present what we believe to be the first report of a patient whose psoriasis improved when therapy with these agents was initiated," the authors write.

 

One author disclosed financial ties to Gilead Sciences.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

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