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Serum cryoglobulin and chronic hepatitis C virus disease among Japanese patients
1Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Insights
Hepatitis C virus (HCV) is a significant cause of cryoglobulins and advanced liver disease in Japanese patients. However, cryoglobulins were less frequent in this population compared to Western studies.
Area of Science:
- Hepatology
- Immunology
- Virology
Background:
- Hepatitis C virus (HCV)-associated mixed cryoglobulins are frequently observed in chronic liver disease.
- The prevalence and characteristics of cryoglobulins in Japanese patients with chronic liver disease require further investigation.
Purpose of the Study:
- To investigate the association between Hepatitis C virus (HCV) and cryoglobulins in Japanese patients with chronic liver disease.
- To compare the prevalence of cryoglobulins in patients with Hepatitis C virus (HCV) and Hepatitis B virus (HBV).
Main Methods:
- Serum levels of total hemolytic complement (CH50) and anti-C3d-binding immune complex were measured in 213 chronic liver disease patients (155 HCV, 58 HBV).
- Cryoglobulins were detected and tested for anti-HCV antibodies and HCV RNA.
- Prevalence of cryoglobulins was correlated with disease severity and duration.
Main Results:
- Lower CH50 activity was observed in Hepatitis C virus (HCV) patients compared to Hepatitis B virus (HBV) patients, except for interferon responders.
- Cryoglobulins were detected in 37% of Hepatitis C virus (HCV) patients, more frequently in cirrhotic patients and those with longer disease duration.
- Patients with cryoglobulins exhibited lower CH50 and higher immune complex levels; anti-HCV antibodies and HCV RNA were present in all tested cryoprecipitates.
Conclusions:
- Hepatitis C virus (HCV) is a primary cause of cryoglobulins and advanced liver damage.
- Serum cryoglobulins with polyclonal immunoglobulins are less common in Japanese patients than in Western populations.
Objectives:
Hepatitis C virus (HCV)-associated mixed cryoglobulins appear to be detected often in hepatitis C-related chronic liver disease. The association of the two phenomenon among Japanese patients is the subject of the present study.
Methods:
Serum levels of total hemolytic complement (CH50) and anti-C3d-binding immune complex, as well as the prevalence of cryoglobulins, were studied in 213 patients with chronic liver disease (hepatitis C, 155; hepatitis B, 58). Cryoprecipitates were tested for anti-HCV Ab and HCV RNA.
Results:
CH50 activity was significantly lower in patients with hepatitis C than in those with hepatitis B except in responders to interferon who showed a sustained loss of HCV RNA. Cryoglobulins were detected in 24 (37%) of 65 patients with hepatitis C; they generally consisted of polyclonal immunoglobulins but one case. Cryoglobulins were more frequently observed in cirrhotic patients and in those with a longer duration of disease. Cryoglobulinemia-related clinical signs such as vasculitis occurred in only three cases. Patients with cryoglobulins had lower CH50 activity and higher immune complex values than those without cryoglobulins. Anti-HCV Ab and HCV RNA were detected in all cryoprecipitates tested.
Conclusions:
These findings suggest that HCV is a major cause of cryoglobulins and advanced liver damage. However, serum cryoglobulins with polyclonal immunoglobulins appear to be less frequent among Japanese patients than among those studied in Western countries.