Viraemia, cryoglobulins and autoantibodies in haemodialysis patients infected with hepatitis C virus.
OBJECTIVE
The clinical features of hepatitis C virus (HCV) infection depend on the immune and autoimmune reactions induced by the virus. Chronic renal failure might alter the pattern of these reactions. The aim of this study was to determine the prevalence of cryoglobulinaemia, the frequency of autoantibodies and HCV viral load in HCV infected Greek patients on chronic haemodialysis.


METHODS
Seventy-three HCV Ab(+) patients on maintenance haemodialysis and 87 otherwise normal patients with chronic HCV infection were evaluated for the presence of cryoglobulins, autoantibodies and viral markers.


RESULTS
Cryoglobulins were detected in 22/73 (30.1%) haemodialysis patients and in 23/87 (26.4%) patients with normal renal function (NS). The mean cryocrit value was significantly lower in the haemodialysis group ( = 0.002). Haemodialysis patients had significantly higher levels of C4 component of complement and lower incidence of rheumatoid factor than those of patients with normal renal function. Serum HCV RNA levels were found significantly lower in the haemodialysis group (median, 2.20 Meq/ml; range, 119.9 Meq/ml) than in the group with normal renal function (median, 4.50 Meq/ml; range, 114.9 Meq/ml; = 0.046). The distribution of genotypes was not different between the two groups.


CONCLUSIONS
There are subtle differences in autoimmune features of HCV infection if the patients are also haemodialysed for renal failure. HCV viral load is lower in haemodialysis patients, with no difference in the HCV genotype prevalence. The clinical significance of these findings is unknown.
Siagris
Dimitrios
D
Department of Internal Medicine, Patras University Hospital, 4 Tertseti Street, Patras 26442, Greece. dsiagris@mland.gr
Labropoulou-Karatza
Chryssoula
C
Christofidou
Myrto
M
Goumenos
Dimitrios
D
Thomopoulos
Konstantinos
K
Lekkou
Alexandra
A
Gogos
Charalambos A
CA
Vlachojannis
John
J
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D003181:Complement C4 / Q000032:analysis; D003449:Cryoglobulinemia / Q000097:blood* / Q000821:virology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000821:virology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D012217:Rheumatoid Factor / Q000097:blood; D019562:Viral Load; D014766:Viremia / Q000097:blood
D001323:Autoantibodies; D003181:Complement C4; D012367:RNA, Viral; D012217:Rheumatoid Factor