OBJECTIVE: To study the association between hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia. SETTING: Wards and clinics of the Ospedali Riuniti di Bergamo and Ospedale di Treviglio e Caravaggio, Italy. PATIENTS: Fifty-one patients with essential mixed cryoglobulinemia associated with glomerulonephritis and 45 controls with noncryoglobulinemic glomerulopathies. MEASUREMENTS: Antibodies to hepatitis C virus (anti-HCV) in sera from patients with essential mixed cryoglobulinemia and from controls, using two enzyme-linked immunosorbent assays (c100 ELISA and c22/c200 ELISA) and a recombinant immunoblot assay (4-RIBA); cryoprecipitate anti-HCV before and after use of dithiothreitol, a substance able to destroy IgM antibodies with rheumatoid factor activity, in patients with essential mixed cryoglobulinemia; serum HCV RNA by polymerase chain reaction in patients with essential mixed cryoglobulinemia. RESULTS: In patients with essential mixed cryoglobulinemia, the c22/c200 ELISA detected anti-HCV in 98% of serum samples (95% CI, 90% to 100%), whereas the rate of reactivity remained at 2% (CI, 0% to 12%) in the control group (P less than 0.0001). These results were confirmed by the 4-RIBA in 66% of patients with essential mixed cryoglobulinemia. The study of cryoprecipitate by c100 ELISA showed anti-HCV in 41% (Cl, 28% to 56%) of patients. After dithiothreitol, the rate of reactivity increased to 94% (CI, 84% to 99%; P less than 0.0001 by the McNemar paired chi-square test), suggesting that the elimination of rheumatoid factor leads to unmasking of anti-HCV in cryoprecipitate. Polymerase chain reaction detected HCV RNA in 13 of 16 sera from patients with essential mixed cryoglobulinemia. CONCLUSIONS: 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.
OBJECTIVE: To study the association between hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia. SETTING: Wards and clinics of the Ospedali Riuniti di Bergamo and Ospedale di Treviglio e Caravaggio, Italy. PATIENTS: Fifty-one patients with essential mixed cryoglobulinemia associated with glomerulonephritis and 45 controls with noncryoglobulinemic glomerulopathies. MEASUREMENTS: Antibodies to hepatitis C virus (anti-HCV) in sera from patients with essential mixed cryoglobulinemia and from controls, using two enzyme-linked immunosorbent assays (c100 ELISA and c22/c200 ELISA) and a recombinant immunoblot assay (4-RIBA); cryoprecipitate anti-HCV before and after use of dithiothreitol, a substance able to destroy IgM antibodies with rheumatoid factor activity, in patients with essential mixed cryoglobulinemia; serum HCV RNA by polymerase chain reaction in patients with essential mixed cryoglobulinemia. RESULTS: In patients with essential mixed cryoglobulinemia, the c22/c200 ELISA detected anti-HCV in 98% of serum samples (95% CI, 90% to 100%), whereas the rate of reactivity remained at 2% (CI, 0% to 12%) in the control group (P less than 0.0001). These results were confirmed by the 4-RIBA in 66% of patients with essential mixed cryoglobulinemia. The study of cryoprecipitate by c100 ELISA showed anti-HCV in 41% (Cl, 28% to 56%) of patients. After dithiothreitol, the rate of reactivity increased to 94% (CI, 84% to 99%; P less than 0.0001 by the McNemar paired chi-square test), suggesting that the elimination of rheumatoid factor leads to unmasking of anti-HCV in cryoprecipitate. Polymerase chain reaction detected HCV RNA in 13 of 16 sera from patients with essential mixed cryoglobulinemia. CONCLUSIONS: 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.
Authors: Meghan E Sise; Allyson K Bloom; Jessica Wisocky; Ming V Lin; Jenna L Gustafson; Andrew L Lundquist; David Steele; Michael Thiim; Winfred W Williams; Nikroo Hashemi; Arthur Y Kim; Ravi Thadhani; Raymond T Chung Journal: Hepatology Date: 2015-12-11 Impact factor: 17.425
Authors: Parag Mahale; Eric A Engels; Ruosha Li; Harrys A Torres; Lu-Yu Hwang; Eric L Brown; Jennifer R Kramer Journal: Gut Date: 2017-06-20 Impact factor: 23.059
Authors: A Gabrielli; A Manzin; M Candela; M L Caniglia; S Paolucci; M G Danieli; M Clementi Journal: Clin Exp Immunol Date: 1994-07 Impact factor: 4.330
Authors: Silvia de Sanjose; Yolanda Benavente; Claire M Vajdic; Eric A Engels; Lindsay M Morton; Paige M Bracci; John J Spinelli; Tongzhang Zheng; Yawei Zhang; Silvia Franceschi; Renato Talamini; Elizabeth A Holly; Andrew E Grulich; James R Cerhan; Patricia Hartge; Wendy Cozen; Paolo Boffetta; Paul Brennan; Marc Maynadié; Pierluigi Cocco; Ramon Bosch; Lenka Foretova; Anthony Staines; Nikolaus Becker; Alexandra Nieters Journal: Clin Gastroenterol Hepatol Date: 2008-04 Impact factor: 11.382