Curing hepatitis C virus (HCV) may not eliminate the risk of liver-related symptoms for those who start treatment with what is known as cryoglobulins. These are clumps of antibodies that can give rise to inflammation and block blood vessels.

Researchers conducted a study of 88 people with HCV who had evidence of cryoglobulins circulating in their bodies, including 46 individuals who had symptoms of HCV-driven cryoglobulinemic vasculitis (inflammation of the blood vessels), or CV, and 42 who did not. The study members, who had an average age of 63 years, were followed for a median of two years after being treated for hep C.

All of the study members were cured of hep C. At their last follow-up visit, 66 percent of those with such vasculitis symptoms and 70 percent of those without such symptoms saw their cryoglobulins clear up.

Out of the group with CV symptoms, five individuals (11 percent) experienced relapses of these symptoms during the study’s follow-up period; health outcomes among them included severe organ damage and death.

“Most clinical manifestations of [hep C] improve over time after viral eradication with direct-acting antivirals,” says the study’s lead author, Martin Bonacci, MD, a hepatologist at the Liver and Digestive Diseases Networking Biomedical Research Centre in Barcelona. “However, in patients with HCV-associated cryoglobulinemic vasculitis, we believe that our data support longer follow-up to make sure recurrence does not occur over time.”