Cryofibrinogen in patients with hepatitis C virus infection.
BACKGROUND
Mixed cryoglobulin is usually associated with hepatitis C virus (HCV) infection and might cause systemic vasculitis. The presence and impact of cryofibrinogen, another cryoprotein, in the serum of HCV-infected patients have not yet been evaluated. The objective was to study the prevalence and the clinical and therapeutic impacts of cryofibrinogen in HCV-infected patients.


METHODS
A total of 143 consecutive HCV-infected (RNA+) patients (including 57 patients with HCV-related vasculitis) were screened for cryofibrinogen and cryoglobulin (positive if >0.05 g/L). The main characteristics and outcome were evaluated according to the cryofibrinogen/cryoglobulin status at baseline.


RESULTS
At baseline, 53 of 143 patients (37%) were cryofibrinogen positive, most of whom (47/53 [89%]) were also cryoglobulin positive. Only 37 of 90 cryofibrinogen-negative patients (41%) were cryoglobulin positive (P<.001). In patients with HCV-related vasculitis, 28 of 57 (49%) were cryofibrinogen positive compared with 25 of 86 patients (29%) without vasculitis (P=.03). There was a higher rate of renal involvement in cryofibrinogen-negative/cryoglobulin-positive patients than in cryofibrinogen-positive/cryoglobulin-positive patients (10/25 [40%] vs 3/27 [11%], respectively; P=.02). After a mean follow-up of 32.6 months, among patients who were cryofibrinogen positive at baseline, 12 of 26 (46%) of those who received an HCV treatment were cryofibrinogen negative at the end of follow-up compared with 4 of 16 (25%) of those who did not receive antiviral drugs. Most patients who became cryofibrinogen negative also became cryoglobulin negative (93%).


CONCLUSIONS
Cryoproteins, including cryoglobulin and cryofibrinogen, are frequently found in the serum of HCV-infected patients. In such patients, a positive cryofibrinogen status is closely related to the presence of cryoglobulin at baseline and after antiviral therapy.
Delluc
Aurélien
A
Service de Médecine Interne, Université Pierre et Marie Curie, Paris 6, France.
Saadoun
David
D
Ghillani-Dalbin
Pascale
P
Sene
Damien
D
Piette
Jean Charles
JC
Cacoub
Patrice
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D003450:Cryoglobulins / Q000032:analysis*; D005260:Female; D015241:Fibrinogens, Abnormal / Q000032:analysis*; D005500:Follow-Up Studies; D015432:Glomerulonephritis, Membranoproliferative / Q000821:virology; D006526:Hepatitis C / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use; D014657:Vasculitis / Q000821:virology
D000998:Antiviral Agents; D003450:Cryoglobulins; D015241:Fibrinogens, Abnormal; D016898:Interferon-alpha; C041874:cryofibrinogen; D012254:Ribavirin