Lunel F, Musset L, Cacoub P, Frangeul L, Cresta P, Perrin M, Grippon P, Hoang C, Valla D, Piette J C
Service de Bactériovirologie, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.
Gastroenterology. 1994 May;106(5):1291-300. doi: 10.1016/0016-5085(94)90022-1.
BACKGROUND/AIMS: Mixed cryoglobulinemia is frequently associated with liver diseases. The respective role of hepatitis C virus (HCV) and liver damage in the pathogenesis of cryoglobulinemia is investigated in this study.
The prevalence of cryoglobulinemia in 226 consecutive patients with chronic liver diseases (hepatitis C, 127; hepatitis B, 40; other diseases, 59) was studied, and the epidemiological, biological, histological, and virological features in these three groups were analyzed. Anti-HCV antibodies, HCV proteins, and HCV RNA were searched in the cryoprecipitates.
The prevalence of mixed cryoglobulinemia was high (41.5%) in patients with liver diseases and higher in patients with hepatitis C (54.3%) than in patients with hepatitis B (15%) or other causes of liver disease (32%). Patients with cryoglobulinemia had cirrhosis more frequently and had a longer history of hepatitis. In patients with hepatitis C, HCV RNA sequences and HCV proteins were detected in the cryoprecipitate. Cryoglobulins became undetectable in 21 of 43 patients treated with interferon.
These findings suggest that HCV is a major cause of cryoglobulinemia. Besides viral infection itself, multiple factors appear to be responsible for the production of cryoglobulins, including cirrhosis and duration of liver disease.
背景/目的：混合性冷球蛋白血症常与肝脏疾病相关。本研究探讨丙型肝炎病毒（HCV）和肝损伤在冷球蛋白血症发病机制中的各自作用。
研究了226例连续的慢性肝病患者（丙型肝炎127例、乙型肝炎40例、其他疾病59例）中冷球蛋白血症的患病率，并分析了这三组患者的流行病学、生物学、组织学和病毒学特征。在冷沉淀物中检测抗HCV抗体、HCV蛋白和HCV RNA。
肝病患者中混合性冷球蛋白血症的患病率较高（41.5%），丙型肝炎患者（54.3%）高于乙型肝炎患者（15%）或其他肝病病因患者（32%）。冷球蛋白血症患者肝硬化更为常见，肝炎病史更长。在丙型肝炎患者中，冷沉淀物中检测到HCV RNA序列和HCV蛋白。43例接受干扰素治疗的患者中有21例冷球蛋白检测不到。
这些发现表明HCV是冷球蛋白血症的主要病因。除病毒感染本身外，多种因素似乎与冷球蛋白的产生有关，包括肝硬化和肝病病程。
