Eloumou Servais Albert Fiacre Bagnaka, Mefo'o Jean Pierre Nda, Nga Winnie Tatiana Bekolo, Kenfack Gabin Ulrich, Yakana Linus, Malongue Agnès, Okalla Cecile, Kowo Mathurin, Andoulo Firmin Ankoune, Tzeuton Christian, Bidja Marie Solange Doualla, Namme Henry Luma, Adiogo Dieudonne, Noah Dominique Noah
Service de Médecine Interne, Hôpital Général de Douala, Douala, Cameroun.
Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun.
Pan Afr Med J. 2019 Jul 4;33:169. doi: 10.11604/pamj.2019.33.169.19162. eCollection 2019.
hepatitis C virus (HCV) has several extra-hepatic manifestations including cryoglubulinemia. Cryoglobulinemia is defined as the abnormal presence in the blood of one or several proteins (cryoglobulins) that can precipitate at low temperatures.
We conducted a cross-sectional analytical study in the Laboratory of Biology and in the Unit of Hepatology of the General Hospital in Douala (HGD) over a period of 6 months. All patients agreeing to participate to the study and with anti-hepatitis-C antibodies under treatment or not were enrolled. Cryoglobulins were detected using biuret method and the classification was performed using Brouet immunoelectrophoresis. A multivariate analysis was conducted, confounding factors such as age, sex and the length of time after Hepatitis C Virus screening were adjusted.
The study enrolled 116 patients. The average age of patients was 58.47±9.95 years. Male sex accounted for 50.86% of cases. Arthralgia was found in 69.80% of cases. Cryoglobulin was found in 63.80% of patients. After adjustment, female sex (OR =2.18; CI 95% [0,97-4,90]; p= 0.059), asthenia alone (OR =2.45;CI 95% [1,04-5,80]; p= 0.041), asthenia combined with arthralgia (OR =2.84;CI 95% [1,13-7, 10]; p= 0.026) and the presence of HCV RNA (OR =2.84;CI 95% [1,13-7,10]; p= 0.028) were factors independently associated with the presence of cryoglobulin.
The prevalence of cryoglobubin is high in patients with anti-hepatitis-C antibodies at the HGD. Simple biological methods are used to detect it. Cryoglobulin test in patients with HCV is essential in resource-limited countries.
丙型肝炎病毒（HCV）有多种肝外表现，包括冷球蛋白血症。冷球蛋白血症定义为血液中一种或几种可在低温下沉淀的蛋白质（冷球蛋白）异常存在。
我们在杜阿拉总医院（HGD）的生物学实验室和肝病科进行了一项为期6个月的横断面分析研究。所有同意参与研究且正在接受或未接受抗丙型肝炎抗体治疗的患者均被纳入。使用双缩脲法检测冷球蛋白，并采用布鲁埃免疫电泳进行分类。进行了多变量分析，对年龄、性别和丙型肝炎病毒筛查后的时间长度等混杂因素进行了调整。
该研究共纳入116例患者。患者的平均年龄为58.47±9.95岁。男性占病例的50.86%。69.80%的病例出现关节痛。63.80%的患者检测到冷球蛋白。调整后，女性（OR =2.18；95%置信区间[0.97 - 4.90]；p = 0.059）、单纯乏力（OR =2.45；95%置信区间[1.04 - 5.80]；p = 0.041）、乏力合并关节痛（OR =2.84；95%置信区间[1.13 - 7.10]；p = 0.026）以及存在HCV RNA（OR =2.84；95%置信区间[1.13 - 7.10]；p = 0.028）是与冷球蛋白存在独立相关的因素。
在HGD，抗丙型肝炎抗体患者中冷球蛋白血症的患病率较高。采用简单的生物学方法进行检测。在资源有限的国家，对HCV患者进行冷球蛋白检测至关重要。
