Cryoglobulinaemia and autoimmune markers in hepatitis C virus infected patients on renal replacement therapy.
OBJECTIVE
To investigate the association of cryoglobulinaemia and autoimmune markers with hepatitis C virus (HCV) infection in patients on maintenance haemodialysis (HD) and post renal transplantation.


METHODS
Serum samples of 103 HCV-antibody (anti-HCV) positive and 105 anti-HCV negative patients were investigated for cryoglobulins. These comprised 136 patients on HD and 72 renal transplant recipients. Serum creatinine and liver function tests were obtained on all patients. Rheumatoid factor (RF), anti nuclear antibodies (ANA), anti smooth muscle antibodies (ASMA), liver kidney microsomal antibodies (LKM), immunoglobulins (Igs) and complement levels were performed on all cryoglobulin positive (cryopositive) samples. HCV RNA and genotyping detection tests were done for cryopositive patients.


RESULTS
The prevalence of cryoglobulins in patients on HD or after renal transplantation was found to be higher (57.6%) among anti-HCV positive patients compared to the anti-HCV negative patients (42.4%) (P=0.000). RF, ANA and ASMA were also higher in cryopositive HCV infected patients. HCV RNA was present in 84.2% of anti-HCV positive patients. Cryoprecipitable RF activity was found in a higher number of symptomatic patients with HCV genotype 1 compared to HCV genotype 3.


CONCLUSIONS
There is an association of cryoglobulinaemia and autoimmune markers in HCV infected patients on HD, and in HCV positive renal transplant recipients. Also HCV genotype 1 is associated with symptomatic mixed cryoglobulinaemia.
Anis
Sabiha
S
Department of Microbiology and Immunology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
Muzaffar
Rana
R
Ahmed
Ejaz
E
Ali
Sabz
S
Nadir
Abdul
A
Naqvi
Anwar
A
Rizvi
Adibul Hassan
AH
D000328:Adult; D015415:Biomarkers; D016022:Case-Control Studies; D003449:Cryoglobulinemia / Q000209:etiology / Q000276:immunology*; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors
D015415:Biomarkers; D018937:Hepatitis C Antibodies