Hello Penn,

There is quiet a strong association between autoimmunity and Hepatitis C. The immune-related extrahepatic manifestations include:

• Mixed cryoglobulinemia
• Cryoglobulinemic vasculitis
• B-cell non-Hodgkin’s lymphoma.
• Sicca syndrome
• Arthralgia/myalgia
• Polyarthritis/fibromyalgia
• Autoantibody production (i.e. cryoglobulins, rheumatoid factor, and antinuclear, anticardiolipin, antithyroid and anti-smooth muscle antibodies)
• Polyarteritis nodosa
• Monoclonal gammopathies
• Immune thrombocytopenia
• Glomerulonephritis and renal insufficiency

This article speaks to your questions https://rmdopen.bmj.com/content/1/1/e000008 with the answer “we just don’t know”.

This article says “use DMARDs with caution in HCV” http://www.eurjrheumatol.org/sayilar/211/buyuk/194-9.pdf

This article suggests slightly lower SVR rates in patients with autoimmunity https://bmjopengastro.bmj.com/content/5/1/e000203

There is a tiny 3 case series here https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-018-0826-7 showing a transient fall in autoantibodies during treatment

But in terms of a study that said something like “patients with HCV and autoimmunity have reduced autoimmunity on and after HCV treatment” – as far as I know nobody has done a large trial to answer that one way or another.

It sounds like you are weighing up treatment options?