nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2022-26-3-30-39nefr-2136Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESКриоглобулинемический васкулит, ассоциированный с HCV-инфекцией: по-прежнему актуальная проблема?Cryoglobulinemic vasculitis associated with HCV infection: still a problem?https://orcid.org/0000-0002-2687-6161МиловановаС. Ю.MilovanovaS. Yu.

Светлана Юрьевна Милованова, проф., д-р мед. наук

кафедра внутренних, профессиональных болезней и ревматологии

119435

ул. Россолимо, д. 11, стр. 4–5

Москва

тел. +79031435050

Svetlana Yu. Milovanova, Professor, Doctor of Medical Sciences

Department of Internal, Occupational Diseases and Rheumatology

119435

Rossolimo str., 11, b. 4-5

Moscow

tel. +79031435050

s.y.milovanova@gmail.comhttps://orcid.org/0000-0001-5835-2269Лысенко (Козловская)Л. В.Lysenko (Kozlovskaya)L. V.

Лидия Владимировна Лысенко (Козловская), д-р мед. наук

кафедра внутренних, профессиональных болезней и ревматологии

119435

ул. Россолимо, д. 11, стр. 4–5

Москва

тел.: +79163044629

Lydia V. Lysenko (Kozlovskaya), Doctor of Medical Sciences

Department of Internal, Occupational Diseases and Rheumatology

119435

Rossolimo str., 11, b. 4-5

Moscow

phone: +79163044629

lidia.v.lysenko@gmail.comhttps://orcid.org/0000-0002-5599-0350МиловановаЛ. Ю.MilovanovaL. Yu.

Людмила Юрьевна Милованова, проф., д-р мед. наук

кафедра внутренних, профессиональных болезней и ревматологии

119435

ул. Россолимо, д. 11, стр. 4–5

Москва

тел.: +79161641400

Lyudmila Yu. Milovanova, Professor, Doctor of Medical Sciences

Department of Internal, Occupational Diseases and Rheumatology

119435

Rossolimo str., 11, b. 4-5

Moscow

phone: +79161641400

ludm.milovanova@gmail.comhttps://orcid.org/0000-0002-3160-2771АбдурахмановДж. Т.AbdurahmanovD. T.

Джамал Тинович Абдурахманов, проф., д-р мед. наук

кафедра внутренних, профессиональных болезней и ревматологии

119435

ул. Россолимо, д. 11, стр. 4–5

Москва

тел.: +79262803431

Jamal T. Abdurakhmanov, Professor, Doctor of Medical Sciences

Department of Internal, Occupational Diseases and Rheumatology

119435

Rossolimo str., 11, b. 4-5

Moscow

phone: +79262803431

abdjamal@mail.ruhttps://orcid.org/0000-0002-7363-6195ТарановаМ. В.TaranovaM. V.

Марина Владимировна Таранова, доц., канд. мед. наук

кафедра внутренних, профессиональных болезней и ревматологии

119435

ул. Россолимо, д. 11, стр. 4–5

Москва

тел.: +79166151255

Marina V. Taranova, Associate Professor, Candidate of Medical Sciences

Department of Internal, Occupational Diseases and Rheumatology

119435

Rossolimo str., 11, b. 4-5

Moscow

phone: +79166151255

mvtaranova@mail.ruhttps://orcid.org/0000-0002-1873-0189ВолковА. В.VolkovA. V.

Алексей Владимирович Волков, доц., канд. мед. наук

кафедра психиатрии и наркологии

119435

ул. Россолимо, д. 11, стр. 9

Москва

тел. +79035892937

Alekseй V. Volkov, Associate professor, MD, PhD

Department of Psychiatry and Narcology

119435

ul. Rossolimo, D. 11, b. 9

Moscow

phone: +79035892937

a-1973b@yandex.ruПервый Московский государственный медицинский университет им. И. М. Сеченова (Сеченовский Университет)РоссияFirst Moscow State Medical University named after I. I. Sechenov (Sechenov University)Russian Federation2022090920222633039Copyright © Милованова С.Ю., Лысенко (Козловская) Л.В., Милованова Л.Ю., Абдурахманов Д.Т., Таранова М.В., Волков А.В., 20222022Милованова С.Ю., Лысенко (Козловская) Л.В., Милованова Л.Ю., Абдурахманов Д.Т., Таранова М.В., Волков А.В.Milovanova S.Y., Lysenko (Kozlovskaya) L.V., Milovanova L.Y., Abdurahmanov D.T., Taranova M.V., Volkov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2136

   В обзоре представлены основные данные, посвященные проблеме криоглобулинемического васкулита (КВ), ассоциированного с HCV-инфекцией. Рассмотрены варианты течения, приведены современные диагностические критерии, выбор тактики и эффективность различных схем лечения. Применение современных противовирусных препаратов позволяет добиться эрадикации вируса у 95 % больных. Однако у некоторых пациентов сохраняются клинические и иммунологические маркеры васкулита, несмотря на элиминацию вируса. В статье обсуждается концепция о том, что персистенция B-клеточных клонов после достижения устойчивого вирусологического ответа может лежать в основе патогенеза HCV-независимой реактивации КВ.

   The review presents the main data on the problem of cryoglobulinemic vasculitis associated with HCV infection. The options for the course are considered, and modern diagnostic criteria, the choice of tactics, and the effectiveness of various treatment regimens are presented. The use of modern antiviral drugs makes it possible to achieve the eradication of the virus in 95 % of patients. However, in some patients, clinical and immunologic markers of vasculitis persist despite viral clearance. The article discusses the concept that the persistence of B-cell clones after achieving a sustained virological response may underlie the pathogenesis of HCV-independent CV reactivation.

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The authors declare that there are no conflicts of interest present.