Serum cryoglobulin and chronic hepatitis C virus disease among Japanese patients.
OBJECTIVE
Hepatitis C virus (HCV)-associated mixed cryoglobulins appear to be detected often in hepatitis C-related chronic liver disease. The association of the two phenomenon among Japanese patients is the subject of the present study.


METHODS
Serum levels of total hemolytic complement (CH50) and anti-C3d-binding immune complex, as well as the prevalence of cryoglobulins, were studied in 213 patients with chronic liver disease (hepatitis C, 155; hepatitis B, 58). Cryoprecipitates were tested for anti-HCV Ab and HCV RNA.


RESULTS
CH50 activity was significantly lower in patients with hepatitis C than in those with hepatitis B except in responders to interferon who showed a sustained loss of HCV RNA. Cryoglobulins were detected in 24 (37%) of 65 patients with hepatitis C; they generally consisted of polyclonal immunoglobulins but one case. Cryoglobulins were more frequently observed in cirrhotic patients and in those with a longer duration of disease. Cryoglobulinemia-related clinical signs such as vasculitis occurred in only three cases. Patients with cryoglobulins had lower CH50 activity and higher immune complex values than those without cryoglobulins. Anti-HCV Ab and HCV RNA were detected in all cryoprecipitates tested.


CONCLUSIONS
These findings suggest that HCV is a major cause of cryoglobulins and advanced liver damage. However, serum cryoglobulins with polyclonal immunoglobulins appear to be less frequent among Japanese patients than among those studied in Western countries.
Tanaka
K
K
Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Aiyama
T
T
Imai
J
J
Morishita
Y
Y
Fukatsu
T
T
Kakumu
S
S
D000328:Adult; D000368:Aged; D002353:Carrier State / Q000097:blood; D002908:Chronic Disease; D015941:Complement Hemolytic Activity Assay; D003450:Cryoglobulins / Q000032:analysis*; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000097:blood; D006526:Hepatitis C / Q000097:blood* / Q000276:immunology / Q000628:therapy / Q000821:virology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis
D003450:Cryoglobulins; D018937:Hepatitis C Antibodies; D016898:Interferon-alpha; D012367:RNA, Viral