Association between cryoglobulinemia and liver fibrosis in chronic hepatitis C patients

Batsaikhan, Batbold; Huang, Ching‐I; Yeh, Ming‐Lun; Huang, Chung‐Feng; Liang, Po‐Cheng; Hsieh, Ming‐Yen; Huang, Jee‐Fu; Yu, Ming‐Lung; Chuang, Wan‐Long; Lee, Jin‐Ching; Lee, Pei‐Lun; Dai, Chia‐Yen

doi:10.1111/jgh.14275

Cited by 9 publications

(14 citation statements)

References 26 publications

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“…However, none of the patients yielded MCS implies that HCV RNA might be crucial in the pathogenesis of MC‐associated vasculitis and eradication of HCV infection is indeed the effective treatment for most MCS patients . In addition, all the differences including gender bias, cirrhosis rate, and IgG, IgM, FIB‐4 and C4 levels observed between the MC (+) and MC (−) patients have been consistently reported in the CHC studies . It did not only strengthen the reliability of our results, but also indicate the core manifestations of HCV‐associated MC, regardless of the presence of the virus.…”

Section: Discussionsupporting

confidence: 82%

Impact of mixed cryoglobulinemia on patients with spontaneous hepatitis C virus clearance: A 13‐year prospective cohort study

Lee

Cheng

Lin

et al. 2019

Eur J Clin Investigation

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Background:The prevalence and associations of mixed cryoglobulinemia (MC) in patients with spontaneous clearance of hepatitis C virus (HCV) remain elusive. Materials and methods: A 13-year prospective cohort study of patients with spontaneous HCV clearance was conducted in a tertiary care centre. Baseline characteristics, incident cardiovascular and neurologic events and cancers were analysed. Results: Of 104 consecutive patients (mean age: 54.08 years old; females: 71 [68%]), 37 (34.6%) had MC and 6 (5.8%) had cirrhosis. MC (+) patients were more female (86% vs 58%, P = .002), had higher rate of cirrhosis (14% vs 1.5%, P = .012), higher levels of Immunoglobulin G (IgG; P = .001), IgM (P = .002) and fibrosis-4 (FIB-4) (P = .004), but lower levels of complement C4 (P = .034) than the MC (−) patients. Female gender (95% confidence interval [CI] of odds ratio: 1.402-26.715), levels of IgG (1.000-1.004), IgM (1.009-1.037) and FIB-4 (1.217-3.966) were independently associated with MC. Baseline rheumatoid factor (RF) levels were independently associated with incident cancer (95% CI hazard ratio [HR]: 1.001-1.030 [HR: 1.015], P = .039). With a cut-off value of 11.3 IU/mL, RF levels significantly predicted incident cancer (area under curve: 0.865, P = .002). No different cumulative incidences of cardiovascular and neurologic events, cancers or mortalities were identified between MC (+) and MC (−) patient. Conclusions: Approximately 1/3 of patients with spontaneous HCV clearance yielded MC, which harboured similar characteristics of MC in patients with chronic hepatitis C. Despite the negligible role of MC in the prognosis of patients with spontaneous HCV clearance, the connection between RF and incident cancer demands further investigation. K E Y W O R D S cancer, hepatitis C virus clearance, mixed cryoglobulinemia, rheumatoid factor 2 of 8 | LEE Et aL.

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Section: Discussionsupporting

confidence: 82%

Impact of mixed cryoglobulinemia on patients with spontaneous hepatitis C virus clearance: A 13‐year prospective cohort study

Lee

Cheng

Lin

et al. 2019

Eur J Clin Investigation

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“…В одном из клинических исследований в результате многофакторного анализа установлено, что главными переменными, связанными с наличием ВПЗ или КГЕ у пациентов с ВГC-инфекцией, являются женский пол, более старший возраст и выраженный фиброз [10]. В других исследованиях определена связь КГЕ с женским полом, не первым генотипом вируса, низкой вирусной нагрузкой и низким уровнем тромбоцитов [13], длительностью ВГC-инфекции [14], более высокой стадией фиброза и циррозом печени [15]. В отдельных исследованиях не было обнаружено взаимосвязи между КГЕ, уровнем РНК ВГC и генотипом вируса [16].…”

Section: Discussionunclassified

Hepatitis C Infections with Cryoglobulinemia: Features and Symptoms

Лукашик¹,

Karpov²,

Krasko³

2021

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Study Objective: To study the incidence of cryoglobulinemia (CGE) in chronic hepatitis C infection (hepatitis C infection) and to analyse the characteristics of chronic hepatitis C infection with CGE in Belarusian patients. Study Design: Open non-randomised observational study. Materials and Methods. The study included 773 patients with chronic hepatitis C infection (in Minsk). The patients had their anti-hepatitis C antibodies, chronic hepatitis C RNA and virus genotype measured; blood cryoglobulins identified; demographic and epidemiological data collected; and complete blood assay and biochemical blood assay performed. Study Results. 282 (36.5%) subjects had positive blood cryoglobulins test, while 491 (63.5%) patients had negative result. CGE and non-CGE groups had comparable sex, BMI and infection duration parameters. CGE patients had statistically more surgeries (р < 0.001), clinical syndromes (including asthenovegetative, arthralgic and dyspeptic syndromes, р < 0.001 in all cases), hepatic fibrosis F3 (р < 0.05), hepatic cirrhosis (р < 0.001), and extrahepatic diseases (EHDs); more often they had genotype 3 of hepatitis C infection (р < 0.05) and low replicative activity of the virus (р < 0.05). Conclusion. The incidence of CGE in the study population made 36.5%. CGE patients had more pronounced hepatic process chronization, frequenter EHDs, more genotype 3 cases, and lower replicative activity of the virus. Keywords: hepatitis С, hepatic cirrhosis, cryoglobulinemia, extrahepatic diseases.

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“…Although the period between HCV infection and developing the end‐stage liver disease (ESLD) is highly variable, on average ~10.0% to 20.0% of the HCV‐positive population progresses to ESLD within 10‐20 years following infection 4 . Besides affecting the liver, HCV may also be associated with extrahepatic complications such as chronic fatigue, autoimmune conditions, renal diseases, and lymphomas 15,16 . The overall number of annual deaths attributed to HCV‐related diseases appears to be on the rise, and the latest figures from the WHO reports estimate that in 2015 the number of deaths from end‐stage HCV infection was 399 000 1…”

Section: Introductionmentioning

confidence: 99%

Characteristics of patients with hepatitis C virus infection and antiviral treatment initiation in Taiwan: The MOSAIC study

Tsai

Chu

et al. 2020

The Kaohsiung J of Med Scie

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Hepatitis C virus (HCV) infection is the leading cause of chronic liver diseases worldwide. Monitoring its epidemiology, diagnosis, and treatment patterns are important for the management of patients with chronic HCV infection from both individual and public health perspectives. The MOSAIC study was an observational study conducted in 20 countries, including Taiwan; its primary objective was to describe epidemiology and treatment initiation patterns in patients seeking HCV care. Of the 111 chronic HCV patients enrolled from Taiwan, 58 (52.3%) had not previously received treatment. HCV genotype 1 was reported in 58 (52.3%) patients, of whom the majority (n = 47; 81.0%) were identified as having subtype 1b. Sixty‐two (55.9%) patients had HCV RNA level > 800 000 IU/mL. Liver cirrhosis was found in 35 (29.3%) patients and was more prevalent in patients who previously received treatment (71.0%). Interferon (IFN)‐based treatment was started within 12 weeks from study inclusion in 12 (10.8%) patients, of whom 11 (91.7%) who had not previously received treatment. Anti‐HCV treatment was not recommended by physicians in 70 (71.4%) and was refused by 23 (23.5%) patients. The MOSAIC study provides data on the epidemiology of HCV infection and IFN‐based treatment decision patterns in Taiwan. Further studies are needed to observe the impact of IFN‐free treatment on the treatment selection pattern.

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Association between cryoglobulinemia and liver fibrosis in chronic hepatitis C patients

Abstract: The prevalence of the presence of serum cryoglobulinemia is 30.4-32% in CHC patients and associated with advanced fibrosis in liver biopsy proven patients and high-FIB4 (≥ 3.25) patients without liver biopsy.

Cited by 9 publications

References 26 publications

Impact of mixed cryoglobulinemia on patients with spontaneous hepatitis C virus clearance: A 13‐year prospective cohort study

Impact of mixed cryoglobulinemia on patients with spontaneous hepatitis C virus clearance: A 13‐year prospective cohort study

Hepatitis C Infections with Cryoglobulinemia: Features and Symptoms

Characteristics of patients with hepatitis C virus infection and antiviral treatment initiation in Taiwan: The MOSAIC study

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