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Clinical and virological findings in mixed cryoglobulinaemia
C Mazzaro1, P Tulissi, M Moretti
1Institute of Medicina Clinica, University of Trieste, School of Medicine, Italy.
Insights
Mixed cryoglobulinaemia is strongly linked to Hepatitis C Virus (HCV) infection, with genotype II being common. This condition often co-occurs with chronic liver disease, lymphomas, and glomerulonephritis.
Area of Science:
- Hepatology
- Virology
- Nephrology
- Hematology
Background:
- A known association exists between mixed cryoglobulinaemia and Hepatitis C Virus (HCV) infection.
- Understanding the clinical, histological, and virological aspects of this association is crucial for patient management.
Purpose of the Study:
- To determine the clinical, histological, and virological findings in patients with mixed cryoglobulinaemia.
- To investigate the prevalence of HCV infection and its genotypes in patients with mixed cryoglobulinaemia.
Main Methods:
- Eighty-two patients with mixed cryoglobulinaemia were enrolled.
- HCV infection was assessed via anti-HCV antibodies and PCR amplification of the 5' untranslated region (5' UTR) and Core region.
- HCV genotyping was performed, and biopsies (bone marrow, liver, kidney) were conducted as indicated.
Main Results:
- A high prevalence of HCV infection was observed (83% seropositive, 85% PCR positive).
- HCV genotype II was prevalent (54%).
- Associated conditions included chronic liver disease (67%), low-grade non-Hodgkin's lymphomas (13%), and membrano-proliferative glomerulonephritis (8%).
Conclusions:
- Mixed cryoglobulinaemia is predominantly associated with HCV infection.
- Various HCV genotypes contribute to the pathogenesis of mixed cryoglobulinaemia.
- The condition is frequently linked to chronic liver disease, non-Hodgkin's lymphomas, and glomerulonephritis.
Objectives:
As a close relationship has been established between mixed cryoglobulinaemia and hepatitis C virus (HCV) infection, the clinical, histological and virological findings of patients affected by mixed cryoglobulinaemia were determined.
Design:
Hepatitis C virus infection was investigated by the presence of anti-HCV antibodies and PCR amplification of the 5' untranslated region (5' UTR), and the genotype of HCV was also determined according to Okamoto. A bone marrow biopsy was performed in all patients and liver and kidney biopsies when indicated.
Subjects:
Eighty-two subjects affected by mixed cryoglobulinaemia were enrolled in this study.
Results:
The prevalence of anti-HCV antibodies was high (83%); PCR amplification of the 5'UTR region was performed in 52 subjects and in 44 of them (85%) the results were positive. In the same subjects, the Core region amplification was positive in 46 cases (88%). A high prevalence of genotype II was found (54%). Chronic liver disease was present in 55 patients (67%). Bone marrow biopsies showed the presence of low-grade non-Hodgkin's lymphomas in 11 cases (13%). Membrano-proliferative glomerulonephritis was found in seven subjects (8%).
Conclusions:
Mixed cryoglobulinaemia is associated with HCV infection in the nearly all cases. Several HCV genotypes are involved in the pathogenesis of this disease. Mixed cryoglobulinaemia is associated with a high prevalence of chronic liver disease, low-grade non-Hodgkin's lymphomas and membrano-proliferative glomerulonephritis.