Hepatitis C Virus Infection in Patients with Essential Mixed Cryoglobulinemia

Misiani, Rocco

doi:10.7326/0003-4819-117-7-573

Cited by 494 publications

(203 citation statements)

References 22 publications

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“…The results suggest that in nondissociated cryoglobulins, the anti-hepatitis C antibodies are blocked by antigen, and are therefore unavailable for detection in anti-hepatitis C virus antibody assays. In contrast to these results, one study (36) showed no significant difference between the prevalence of hepatitis C virus antibody in sera and cryoprecipitates. In that study, reduction of the cryoprecipitates with dithiothreitol (DTT) increased the c 100 antibody detected by first-generation ELISA.…”

Section: $ By First-generation Enzyme-linked Immunosorbent Assay (Elimentioning

confidence: 68%

Hepatitis c virus infection in type ii mixed cryoglobulinemia

Ábel

Zhang

Agnello

1993

Arthritis & Rheumatism

115

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Type I1 mixed cryoglobulinemia is characterized by symptoms of systemic vasculitis and hepatic involvement. The cryoglobulins consist of polyclonal IgG complexed with monoclonal IgM rheumatoid factors (RF) that predominantly bear the WA crossidiotype (XId). Because of the high prevalence of hepatocellular abnormalities associated with the disease, hepatotropic viruses have been suspected as causative agents. Although hepatitis B virus was implicated in the pathogenesis of essential mixed cryoglobulinemia in early studies, evidence for ongoing hepatitis B infection in these patients was rarely found.Recently, an association of hepatitis C virus infection with type I1 mixed cryoglobulinemia has been established. Hepatitis C virus infection occurs in type I1 mixed cryoglobulinemia patients most commonly in association with WA monoclonal RF (mRF). This association raises the hypothesis that WA mRF is an antibody that cross-reacts with hepatitis C virus and that the virus is the causative agent of type I1 mixed cryoglobulinemia. The possibility that hepatitis C virus and WA RF play a role in mixed cryoglobu-

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Section: $ By First-generation Enzyme-linked Immunosorbent Assay (Elimentioning

confidence: 68%

Hepatitis c virus infection in type ii mixed cryoglobulinemia

Ábel

Zhang

Agnello

1993

Arthritis & Rheumatism

115

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“…Increasing evidence suggests that the hepatitis C virus (HCV) is the causative agent of the so-called mixed cryoglobulinemia (MC) [1][2][3][4] and that it might be involved in the pathogenesis of B cell non-Hodgkin's lymphomas (NHL) complicating MC 5,6 or arising 'de novo'. 7 On the basis of its prevalence among 537 patients with different lymphoproliferative disorders, 180 with MGUS (monoclonal gammopathy of unknown significance), and 470 with B cell NHL, we previously identified the B cell NHL (in particular the immunocytoma) associated with the production of cryoglobulins (in particular type II), as the probable pathogenetic target of HCV.…”

Section: Introductionmentioning

confidence: 99%

The genotype of the hepatitis C virus in patients with HCV-related B cell non-Hodgkin’s lymphoma

et al. 1997

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Increasing evidence suggests that the hepatitis C virus (HCV) might be involved in the pathogenesis of B cell non-Hodgkin's lymphomas (NHL). Since several HCV genotypes are currently identifiable and might be involved in the pathogenesis of different diseases (with different severity and responsiveness to therapy), the aim of our study was to assess the prevalence of viral genotypes in a group of patients with HCV-related NHL. Among 470 consecutive patients, 42 HCV Ab-positive cases were identified. HCV RNA could be detected by reverse transcriptase-polymerase chain reaction and genotyping performed in 31 of these cases. As compared to our control group (211 healthy blood donors and patients with chronic liver disease), a striking high prevalence of genotype 2ac was detected among B cell NHL (48.4 vs 9.0%), with a relative risk of infection of 5.37 (P Ͻ 0.0001). No major differences were observed in the distribution of NHL histotypes and in the clinical features among patients with genotype 1b (the other most frequent genotype) or 2ac, a part from a trend towards a higher percentage of liver disease and a lower likelihood of response to interferon for patients with genotype 1b. The same high prevalence of genotype 2ac has been recently reported in patients with mixed cryoglobulinemia (MC), monoclonal gammopathies, B cell NHL complicating MC and autoimmune hepatitis. All these data taken together suggest that genotype 2ac might be involved in the pathogenesis of lymphoproliferative and autoimmune disorders.

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“…While mixed cryoglobulins have been described in 50% of patients with chronic HCV infection (l), 53-82% of patients with mixed cryoglobulinemia had chronic HCV infection, and this virus is now considered to be an etiologic agent for mixed cryoglobulinemia (2)(3)(4). Latent autoimmune thyroid disease, glomerulonephritis, polymyositis, and pulmonary fibrosis have been reported in association with HCV (5)(6)(7)(8).…”

mentioning

confidence: 99%

Sicca syndrome associated with hepatitis C virus infection

Jørgensen

Legouffe

Perney

et al. 1996

Arthritis & Rheumatism

135

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Objective. To determine the prevalence of hepatitis C virus (HCV) infection in patients with sicca syndrome, and to determine the clinical, immunologic, and genetic characteristics of sicca syndrome associated with HCV.Methods. We conducted a prospective study in a university hospital immunology-rheumatology department. Sixty-two consecutive patients with sicca syndrome according to the European criteria for Sjogren's syndrome were included. HCV infection was diagnosed in patients with positive recombinant immunoblot assay findings and the presence of viral RNA in serum and saliva. Rheumatoid factor (RF), cryoglobulins, antinuclear antibodies, and anti-SS-NSS-B antibodies were sought. HLA typing was performed on all patients.Results. The prevalence of HCV infection in patients with sicca syndrome was 19%. The incidence of neurologic involvement was significantly increased in patients with sicca syndrome associated with HCV infection (24% versus 4%; P c 0.03), as was elevations in transaminase levels (87.5% versus 16%; P < 0.0001). RF and cryoglobulins were more frequent in HCV-positive sicca syndrome patients (62% versus 30%; P C 0.03, and 56% versus 10%; P c 0.001, respectively). In contrast, anti-SS-NSS-B antibodies were present in 38% of HCVnegative sicca syndrome patients, but in only 1 HCVpositive sicca syndrome patient (P c 0.01). No significant difference in HLA type was observed. Viral RNA

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Hepatitis C Virus Infection in Patients with Essential Mixed Cryoglobulinemia

Abstract: The extremely high prevalence of anti-HCV in serum and cryoprecipitate along with the frequently associated serum HCV RNA suggests a close relation between essential mixed cryoglobulinemia and chronic HCV infection.

Cited by 494 publications

References 22 publications

Hepatitis c virus infection in type ii mixed cryoglobulinemia

Hepatitis c virus infection in type ii mixed cryoglobulinemia

The genotype of the hepatitis C virus in patients with HCV-related B cell non-Hodgkin’s lymphoma

Sicca syndrome associated with hepatitis C virus infection

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