TY - JOUR
T1 - Prevalence and risk factors for the presence of serum cryoglobulins in patients with chronic hepatitis C
AU - Cicardi, M.
AU - Cesana, B.
AU - Del Ninno, E.
AU - Pappalardo, E.
AU - Silini, E.
AU - Agostoni, A.
AU - Colombo, M.
PY - 2000
Y1 - 2000
N2 - To assess the prevalence and risk factors for cryoglobulinaemia associated with hepatitis C virus (HCV) infection, we studied 360 consecutive patients with chronic hepatitis C (191 men, median age 57 years; 86 [24%] with cirrhosis). One-hundred and sixty-eight (47%) had circulating cryoglobulins (mean levels 208 ± 256 mg l
-1), predominantly of type III (80%; and 20% type II). Cryoglobulins were more common in women than in men (56% vs 39%, P = 0.001) and in patients with cirrhosis than in those with chronic hepatitis (57% vs 43%, P = 0.024). Cryoglobulinaemic patients more frequently had high levels of serum immunoglobulin M (IgM) (57% vs 30%, P = 0.001), immunoglobulin G (IgG) (84% vs 70%, P = 0.002) and rheumatoid factor (45% vs 16%, P = 0.001); low levels of serum C3 (15% vs 4%, P = 0.001) and C4 (51% vs 26%, P = 0.001); and low numbers of platelets (21% vs 12%, P = 0.018), than patients without cryoglobulins. The presence of cryoglobulins was not correlated with hepatitis duration (cryopositives, 12 ± 7 years; cryonegatives, 11 ± 8 years) or HCV genotype (HCV 1b, 48% vs 53%; HCV 2a 35% vs 29%, cryopositive vs cryonegative patients respectively). By multivariate analysis, female gender (odds ratio [OR] 1.675; confidence interval [CI] 1.055-2.661), elevated serum IgM (OR 2.296; CI 1.438-3.665), IgG (OR 1.952; CI 1.114-3.422), rheumatoid factor (OR 3.213: CI 1.8895.465) and low C4 (OR 1.859; CI 1.138-3.038) could reliably predict the presence of cryoglobulins. When the pathogenic variables IgG, rheumatoid factor and C4 were excluded from analyses, only levels of serum cholinesterase activity <4500 U independently predicted (OR 3.663, CI 1.258-10.184) the presence of cryoglobulins. Fifty per cent of the patients with chronic hepatitis C circulated cryoglobulins, with preference for those with a greater impairment of liver function, as revealed by serum cholinesterase activity.
AB - To assess the prevalence and risk factors for cryoglobulinaemia associated with hepatitis C virus (HCV) infection, we studied 360 consecutive patients with chronic hepatitis C (191 men, median age 57 years; 86 [24%] with cirrhosis). One-hundred and sixty-eight (47%) had circulating cryoglobulins (mean levels 208 ± 256 mg l
-1), predominantly of type III (80%; and 20% type II). Cryoglobulins were more common in women than in men (56% vs 39%, P = 0.001) and in patients with cirrhosis than in those with chronic hepatitis (57% vs 43%, P = 0.024). Cryoglobulinaemic patients more frequently had high levels of serum immunoglobulin M (IgM) (57% vs 30%, P = 0.001), immunoglobulin G (IgG) (84% vs 70%, P = 0.002) and rheumatoid factor (45% vs 16%, P = 0.001); low levels of serum C3 (15% vs 4%, P = 0.001) and C4 (51% vs 26%, P = 0.001); and low numbers of platelets (21% vs 12%, P = 0.018), than patients without cryoglobulins. The presence of cryoglobulins was not correlated with hepatitis duration (cryopositives, 12 ± 7 years; cryonegatives, 11 ± 8 years) or HCV genotype (HCV 1b, 48% vs 53%; HCV 2a 35% vs 29%, cryopositive vs cryonegative patients respectively). By multivariate analysis, female gender (odds ratio [OR] 1.675; confidence interval [CI] 1.055-2.661), elevated serum IgM (OR 2.296; CI 1.438-3.665), IgG (OR 1.952; CI 1.114-3.422), rheumatoid factor (OR 3.213: CI 1.8895.465) and low C4 (OR 1.859; CI 1.138-3.038) could reliably predict the presence of cryoglobulins. When the pathogenic variables IgG, rheumatoid factor and C4 were excluded from analyses, only levels of serum cholinesterase activity <4500 U independently predicted (OR 3.663, CI 1.258-10.184) the presence of cryoglobulins. Fifty per cent of the patients with chronic hepatitis C circulated cryoglobulins, with preference for those with a greater impairment of liver function, as revealed by serum cholinesterase activity.
KW - B lymphocytes
KW - Cirrhosis
KW - Complement
KW - Cryoglobulins
KW - HCV genotype
KW - Rheumatoid factor
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U2 - 10.1046/j.1365-2893.2000.00204.x
DO - 10.1046/j.1365-2893.2000.00204.x
M3 - Article
C2 - 10760044
AN - SCOPUS:0034108710
VL - 7
SP - 138
EP - 143
JO - Journal of Viral Hepatitis
JF - Journal of Viral Hepatitis
SN - 1352-0504
IS - 2
ER -