Off-Label Use of Ribavirin in Management of Mucocutaneous Extrahepatic Manifestations of HCV Infection
Off-Label Use of Ribavirin in Management of Mucocutaneous Extrahepatic Manifestations of HCV Infection
This study will be conducted on 30 patients with mucocutaneous complaints and documented HCV
 infection. The study will be done at Tropical medicine department , Tanta university. It will
 be conducted between June2014 and November 2014.

 The aim of the study is to assess efficacy of Ribavirin in the management of mucocutaneous
 extrahepatic manifestations of HCV infection.
Hepatitis C virus is a common cause of chronic liver disease worldwide and represent public
 health problem. The Egyptian Demographic Health Survey (EDHS), a cross sectional survey
 including hepatitis C virus (HCV) biomarkers, was conducted in 2008 on a large nationally
 representative sample. It estimated HCV prevalence among the 15-59 years age group to be
 14.7% . Accordingly, Egypt has the highest HCV prevalence in the world.

 Although HCV is a hepatotropic virus, in some patients the primary manifestations of
 infection occur outside the liver. There is a growing body of evidence to support the idea
 that HCV can replicate efficiently in extrahepatic tissues including the Peripheral blood
 mononuclear cells (PBMC). Autoimmune manifestations are common in patients chronically
 infected by HCV . These manifestations can be dominant, whereas the hepatic disease can be
 quiescent or mild. More recently, there has been growing interest in the relationship between
 HCV and Sjogren's syndrome (SS), rheumatoid arthritis (RA), and systemic lupus erythematosus
 (SLE).

 Of those , this article is interested in cutaneous and mucous membrane manifestations where
 many reports have shown that cutaneous manifestations are often the first signs of chronic
 HCV infection and these are indicated in 20-40% of the patients presenting to the dermatology
 clinics, therefore dermatologists must be aware of skin disorders associated with viral
 infection. The most commonly encountered dermatological manifestations of HCV infection
 includes mixed cryoglobulinemia (MC), porphyria cutanea tarda (PCT), cutaneous and/or oral
 lichen planus (LP), urticaria, pruritus, thrombocytopenic purpura and cutaneous vasculitis.
 Although majority of skin manifestations of chronic HCV infection represent the clinical
 impression of autoimmune phenomena, however, precise pathogenesis of these extra-hepatic
 complications is not well understood.

 The aim of the study is to assess efficacy of Ribavirin in the management of mucocutaneous
 extrahepatic manifestations of HCV infection

 This study will be conducted on 30 patients with mucocutaneous complaints and documented HCV
 infection. The study will be done at Tropical medicine department , Tanta university. It will
 be conducted between June2014 and November 2014.
Inclusion Criteria:

 -  Patients with evidence of HCV infection and mucocutaneous complaint and
 contraindicated to have standard antiviral therapy.

 Exclusion Criteria:

 -  Hypersensitivity to Ribavirin

 -  Pregnant & Lactating women

 -  Male partners of pregnant women