Prevalence and risk factors for the presence of serum cryoglobulins in patients with chronic hepatitis C

To assess the prevalence and risk factors for cryoglobulinaemia associated with hepatitis C virus (HCV) infection, we studied 360 consecutive patients with chronic hepatitis C (191 men, median age 57 years; 86 [24%] with cirrhosis). One‐hundred and sixty‐eight (47%) had circulating cryoglobulins (me...

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Bibliographic Details
Published in:Journal of viral hepatitis 2000-03, Vol.7 (2), p.138-143
Main Authors: Cicardi, M, Cesana, B, Del Ninno, E, Pappalardo, E, Silini, E, Agostoni, A, Colombo, M
Format: Article
Language:English
Subjects:
Adult
Aged
B lymphocytes
Biomarkers
cirrhosis
complement
cryoglobulins
Cryoglobulins - analysis
Female
HCV genotype
Hepatitis C virus
Hepatitis C, Chronic - blood
Hepatitis C, Chronic - epidemiology
Humans
Italy - epidemiology
Male
Middle Aged
Multivariate Analysis
Prevalence
rheumatoid factor
Risk Factors
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Summary:To assess the prevalence and risk factors for cryoglobulinaemia associated with hepatitis C virus (HCV) infection, we studied 360 consecutive patients with chronic hepatitis C (191 men, median age 57 years; 86 [24%] with cirrhosis). One‐hundred and sixty‐eight (47%) had circulating cryoglobulins (mean levels 208 ± 256 mg l−1), predominantly of type III (80%; and 20% type II). Cryoglobulins were more common in women than in men (56% vs 39%, P=0.001) and in patients with cirrhosis than in those with chronic hepatitis (57% vs 43%, P=0.024). Cryoglobulinaemic patients more frequently had high levels of serum immunoglobulin M (IgM) (57% vs 30%, P=0.001), immunoglobulin G (IgG) (84% vs 70%, P=0.002) and rheumatoid factor (45% vs 16%, P=0.001); low levels of serum C3 (15% vs 4%, P=0.001) and C4 (51% vs 26%, P=0.001); and low numbers of platelets (21% vs 12%, P=0.018), than patients without cryoglobulins. The presence of cryoglobulins was not correlated with hepatitis duration (cryopositives, 12 ± 7 years; cryonegatives, 11 ± 8 years) or HCV genotype (HCV 1b, 48% vs 53%; HCV 2a, 35% vs 29%, cryopositive vs cryonegative patients respectively). By multivariate analysis, female gender (odds ratio [OR] 1.675; confidence interval [CI] 1.055–2.661), elevated serum IgM (OR 2.296; CI 1.438–3.665), IgG (OR 1.952; CI 1.114–3.422), rheumatoid factor (OR 3.213; CI 1.889–5.465) and low C4 (OR 1.859; CI 1.138–3.038) could reliably predict the presence of cryoglobulins. When the pathogenic variables IgG, rheumatoid factor and C4 were excluded from analyses, only levels of serum cholinesterase activity
ISSN:1352-0504
1365-2893
DOI:10.1046/j.1365-2893.2000.00204.x