Cryoglobulinemia in chronic liver diseases: role of hepatitis C virus and liver damage.
OBJECTIVE
Mixed cryoglobulinemia is frequently associated with liver diseases. The respective role of hepatitis C virus (HCV) and liver damage in the pathogenesis of cryoglobulinemia is investigated in this study.


METHODS
The prevalence of cryoglobulinemia in 226 consecutive patients with chronic liver diseases (hepatitis C, 127; hepatitis B, 40; other diseases, 59) was studied, and the epidemiological, biological, histological, and virological features in these three groups were analyzed. Anti-HCV antibodies, HCV proteins, and HCV RNA were searched in the cryoprecipitates.


RESULTS
The prevalence of mixed cryoglobulinemia was high (41.5%) in patients with liver diseases and higher in patients with hepatitis C (54.3%) than in patients with hepatitis B (15%) or other causes of liver disease (32%). Patients with cryoglobulinemia had cirrhosis more frequently and had a longer history of hepatitis. In patients with hepatitis C, HCV RNA sequences and HCV proteins were detected in the cryoprecipitate. Cryoglobulins became undetectable in 21 of 43 patients treated with interferon.


CONCLUSIONS
These findings suggest that HCV is a major cause of cryoglobulinemia. Besides viral infection itself, multiple factors appear to be responsible for the production of cryoglobulins, including cirrhosis and duration of liver disease.
Lunel
F
F
Service de Bactériovirologie, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.
Musset
L
L
Cacoub
P
P
Frangeul
L
L
Cresta
P
P
Perrin
M
M
Grippon
P
P
Hoang
C
C
Valla
D
D
Piette
J C
JC
D000328:Adult; D001483:Base Sequence; D002908:Chronic Disease; D003449:Cryoglobulinemia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000502:physiology*; D006526:Hepatitis C / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008099:Liver / Q000473:pathology* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008107:Liver Diseases / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics
D004279:DNA, Viral; D012367:RNA, Viral; D007372:Interferons