Improvement in Waldenstrom’s macroglobulinemia after successful treatment of HCV with direct-acting antivirals

Chronic hepatitis C (HCV) virus infection may be associated with several non-hepatic manifestations, mainly driven by chronic im-mune stimulation, such as mixed cryoglobulinemia and Non-Hodgkin’s Lymphoma. This association has been proved by severalmeta-analyses and some interventional studies demonstrating that antiviral treatment may be effective in inducing HCV-associatedlymphoma regression. The recent advent of direct acting antivirals (DAAs) in the therapeutic armamentarium of HCV infection madepossible treatment of patients with advanced liver disease. Here we report on a rare association of a cirrhotic patient with HCV andWaldenström’s Macroglobulinemia with severe cryoglobulinemia, who had already failed an interferon-based antiviral regimen, whosehaematologic disease was ameliorated by HCV eradication following treatment with sofosbuvir and simeprevir with ribavirin, andwhere successful treatment was accompanied also by consistent improvement in liver function and parameters of portal hyperten-sion.