Influence of age and autoimmunity on liver disease in HCV-associated type II mixed cryoglobulinemia.
It has been suggested that hepatitis C virus (HCV) infected patients with type II mixed cryoglobulinemia have less extensive liver damage than patients without cryoglobulinemia. We retrospectively evaluated 35 patients with type II mixed cryoglobulinemia associated with HCV infection, seeking for factors associated with normal alanine aminotransferase (ALT) values. The presence of anti-GOR and of other autoantibodies, including the recently described anti-LAG-3.1, was specifically investigated. Fifty-four percent of patients had anti-GOR, 46% anti-LAG-3.1, 40% anti-smooth muscle, 17% anti-nuclear, and 11% anti-liver-kidney microsome 1 antibodies. Anti-GOR was significantly (p = 0.037) associated with anti-LAG-3.1 but not with other autoantibodies. Persistently abnormal ALT levels were observed in 54% of patients. By univariate analyses, abnormal ALT was significantly associated with anti-GOR positivity (p = 0.018) and younger age (p = 0.03). Multivariate regression analysis confirmed that these variables were independently associated with abnormal ALT. Our data suggest that the presence of autoimmune manifestations as well as unidentified age-related host factor(s) may protect from liver injury in HCV-associated cryoglobulinemia.
De Rosa
Francesco G
FG
Clinica Malattie Infettive, University of Turin, Turin, Italy.
Pucillo
Leopoldo P
LP
Coviello
Rossella
R
Pirro
Maria Rosaria
MR
Fiaschetti
Pamela
P
Candela
Marco
M
Gabrielli
Armando
A
Laganà
Bruno
B
Fiorilli
Massimo
M
Casato
Milvia
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D000941:Antigens / Q000276:immunology; D015703:Antigens, CD; D001323:Autoantibodies / Q000097:blood; D015551:Autoimmunity; D003449:Cryoglobulinemia / Q000145:classification / Q000150:complications* / Q000276:immunology*; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology / Q000276:immunology*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000276:immunology; D008875:Middle Aged; D012189:Retrospective Studies; D000093322:Lymphocyte Activation Gene 3 Protein
D000974:Antibodies, Antinuclear; D000941:Antigens; D015703:Antigens, CD; D001323:Autoantibodies; D008565:Membrane Proteins; C433683:REXO1L1P protein, human; D000410:Alanine Transaminase; D000093322:Lymphocyte Activation Gene 3 Protein; C000720326:Lag3 protein, human