Immunological disorders in C virus chronic active hepatitis: a prospective case-control study.
Hepatitis C virus-related chronic hepatitis may be associated with various immunological disorders. The aim of this study was to determine prospectively the prevalence of the clinical, biochemical and pathological immunological abnormalities in a series of 61 consecutive patients with chronic hepatitis C, compared with those in 61 age- and sex-matched control subjects without markers of hepatitis C virus and hepatitis B virus infections and with those in 61 patients with chronic hepatitis B. The following investigations were systematically performed before any treatment: detection of serum cryoglobulinemia and rheumatoid factor, detection of a large variety of serum anti-tissue antibodies, biopsy of labial salivary glands, ophthalmological examination, dosage of thyroid-stimulating hormone and in vivo capillary microscopy. Cryoglobulinemia was found in 36% of the hepatitis C virus patients, four of whom had dermatological and/or neurological manifestations of vasculitis, and rheumatoid factor was present in 70%. Serum anti-tissue antibodies were detected in 41% of cases, mostly antinuclear and anti-smooth muscle antibodies. Liver-kidney microsomal and antithyroid antibodies were rare. Salivary gland lesions were found in 49% of the patients: all had lymphocytic capillaritis, sometimes associated with lymphocytic sialadenitis resembling that of Sjögren's syndrome, but without features of sicca syndrome and Ro/SSA antibodies. Five percent of the patients had lichen planus. The prevalences of cryoglobulinemia, rheumatoid factor and anti-tissue antibodies were significantly higher than those in the control group and patients with chronic hepatitis B.(ABSTRACT TRUNCATED AT 250 WORDS)
Pawlotsky
J M
JM
Department of Bacteriology and Virology, Hôpital Henri Mondor-Université Paris XII, Creteil, France.
Ben Yahia
M
M
Andre
C
C
Voisin
M C
MC
Intrator
L
L
Roudot-Thoraval
F
F
Deforges
L
L
Duvoux
C
C
Zafrani
E S
ES
Duval
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D003449:Cryoglobulinemia / Q000150:complications; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000276:immunology*; D006521:Hepatitis, Chronic / Q000150:complications / Q000276:immunology*; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D012469:Salivary Glands / Q000473:pathology; D012793:Sialadenitis / Q000150:complications
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D012217:Rheumatoid Factor