Cryoglobulinemia and progression of fibrosis in chronic HCV infection: cause or effect?

Objectives. Mixed cryoglobulinemia (MC) is the most common extrahepatic manifestation of HCV infection. The aim of this study is to determine the prevalence of MC in HCV infected Greek patients and to identify if it is associated with liver histology or the mode of HCV transmission. Methods. One hun...

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Bibliographic Details
Published in:The Journal of infection 2004-10, Vol.49 (3), p.236-241
Main Authors: Siagris, Dimitrios, Christofidou, Myrto, Tsamandas, Athanasios, Lekkou, Alexandra, Thomopoulos, Konstantinos, Labropoulou-Karatza, Chryssoula
Format: Article
Language:English
Subjects:
Autoantibodies
Autoantibodies - isolation & purification
Biological and medical sciences
Cryoglobulinemia - complications
Cryoglobulinemia - epidemiology
Cryoglobulins
Female
Fibrosis - complications
Fibrosis - pathology
Genotype
Greece - epidemiology
HCV genotypes
Hepatitis C virus
Hepatitis C, Chronic - blood
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - pathology
Human viral diseases
Humans
Infectious diseases
Liver histology
Male
Medical sciences
Middle Aged
Prevalence
Rheumatoid Factor - blood
Viral diseases
Viral hepatitis
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Summary:Objectives. Mixed cryoglobulinemia (MC) is the most common extrahepatic manifestation of HCV infection. The aim of this study is to determine the prevalence of MC in HCV infected Greek patients and to identify if it is associated with liver histology or the mode of HCV transmission. Methods. One hundred and twenty-six patients with chronic HCV infection were evaluated for the presence of serum cryoglobulins, autoantibodies and viral markers. One hundred and eighteen of them underwent liver biopsy and each specimen was evaluated according to the grading and staging system described by Ishak et al. Results. Cryoglobulins were detected in 37/126 (29.4%) HCV patients and cryocrit values ranged between 0.5 and 6.5%. Only two patients presented clear clinical manifestations of MC. In patients with MC, a higher grading (6.40±2.06 vs. 5.27±2.55, p=0.013) and staging score (3.71±1.45 vs. 2.83±1.84, p=0.007) was noted in liver biopsy compared to those without MC. Logistic regression analysis identified staging score (OR, 1.33; CI, 1.06–1.66, p=0.015) as the only independent variable associated with cryoglobulinemia. Correlation between the presence of cryoglobulins and the mode of HCV transmission was not found. Conclusions. Greek patients with chronic HCV infection have high prevalence of cryoglobulinemia. A clear association between the presence of serum cryoglobulins and staging score of chronic hepatitis was found, with no difference in patients' age or the duration of infection. It is possible that cryoglobulinemia results in more rapid hepatic fibrosis in HCV infected patients.
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2004.05.002