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Cryoglobulinaemia and rheumatic manifestations in patients with hepatitis C virus infection
1Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
Insights
Hepatitis C virus (HCV) infection is common in Korean patients with cryoglobulinaemia, a condition causing various rheumatological symptoms. These symptoms did not differ between those with and without cryoglobulinaemia, suggesting HCV as a potential cause for unexplained rheumatic conditions.
Area of Science:
- Rheumatology
- Hepatology
- Immunology
Background:
- Hepatitis C virus (HCV) infection is a significant global health concern.
- Cryoglobulinaemia is a condition characterized by the presence of cryoglobulins in the blood, often associated with autoimmune disorders and infections.
- Rheumatic manifestations are frequently observed in patients with chronic HCV infection.
Purpose of the Study:
- To investigate the prevalence and characteristics of cryoglobulinaemia in Korean patients with HCV infection.
- To explore the association between cryoglobulinaemia and various rheumatic manifestations in this patient cohort.
- To determine the types of cryoglobulins and their relationship with clinical features.
Main Methods:
- A cohort of 49 Korean patients with HCV infection was studied.
- Cryoglobulin prevalence, concentration, and type (using immunofixation) were assessed.
- Rheumatoid factor (RF), antinuclear antibody (ANA), HCV genotype, and rheumatological symptoms were evaluated.
Main Results:
- Cryoglobulinaemia was detected in 59% of Korean HCV patients, with all identified cases being type III.
- No significant differences in demographic factors, liver cirrhosis, or HCV genotype were found between patients with and without cryoglobulinaemia.
- While various rheumatological symptoms like arthralgia, cutaneous manifestations, and paresthesia were common, they did not significantly differ between the cryoglobulinaemia and non-cryoglobulinaemia groups.
Conclusions:
- HCV patients frequently exhibit cryoglobulinaemia and diverse rheumatological symptoms.
- The study suggests that HCV infection should be considered in the differential diagnosis of patients presenting with unexplained rheumatological symptoms, even in the absence of distinct differences between cryoglobulinaemic and non-cryoglobulinaemic groups.
Objectives:
To investigate the association of cryoglobulinaemia and rheumatic manifestations in Korean patients with hepatitis C virus (HCV) infection.
Methods:
Forty nine Korean patients with HCV infection were recruited. The prevalence, concentration, and type of cryoglobulin (by immunofixation), rheumatoid factor (RF), antinuclear antibody (ANA), and various rheumatological symptoms were investigated and HCV genotype was determined by polymerase chain reaction with genotype specific primer.
Results:
The prevalence of cryoglobulin was 59% in Korean HCV patients and the concentration of cryoglobulin was 9.8 (7.9) g/l (mean (SD)). The type of cryoglobulinaemia was identified in 23 (80%) of 29 HCV patients with cryoglobulinaemia and they were all type III. There were no differences in age, sex, history of operation and transfusion, proportion of liver cirrhosis between the patients with cryoglobulinaemia and those without cryoglobulinaemia. The frequencies of RF and ANA were 14% and 3.4% respectively in HCV patients with cryoglobulinaemia. There was no difference in HCV genotype between the patients with cryoglobulinaemia and those without cryoglobulinaemia. Clinical features of HCV patients were as follows: arthralgia/arthritis (35%), cutaneous manifestation (37%), Raynaud's phenomenon (8%), paresthesia (44%), dry eyes (22%), dry mouth (10%), oral ulcer (33%), and abdominal pain (14%). However, these rheumatological symptoms did not differ between the two groups.
Conclusion:
Although the rheumatological symptoms were not different between HCV patients with and without cryoglobulinaemia, HCV patients showed various rheumatological manifestations. These result suggests that HCV infection could be included as one of the causes in patients with unexplained rheumatological symptoms.