Frangeul L, Musset L, Cresta P, Cacoub P, Huraux J M, Lunel F
Service de Virologie, Hopital Pitié-Salpétrière, Paris, France.
J Hepatol. 1996 Oct;25(4):427-32. doi: 10.1016/s0168-8278(96)80200-5.
BACKGROUND/AIMS: Recent reports have shown a high frequency of anti-hepatitis C virus antibodies in patients with cryoglobulinemia. The factors involved in the production of cryoglobulins in hepatitis C virus-infected patients are unknown. To assess the role of hepatitis C virus genotypes in the pathogenesis of mixed cryoglobulinemia, we analyzed their prevalence in a group of 118 hepatitis C virus-infected patients according to the presence or absence of cryoglobulins.
The hepatitis C virus genome was typed using the Line Probe Assay (LiPA, Innogenetics), for the most common genotypes (1a, 1b, 2a, 2b, 3, 4 or 5).
Cryoglobulinemia was diagnosed in 60 (51%) patients, 33 (55%) of whom had type II and 27 (45%) type III cryoglobulins. Forty-four (37%) patients had no cryoglobulinemia and 14 (12%) patients had transient cryoglobulins. Cryoglobulins were significantly less prevalent in patients infected by genotype 1a. We found no statistical link between the hepatitis C virus genotype and the presence of symptomatic cryoglobulinemia, or the hepatitis C virus genotype and the type (II or III) of cryoglobulin. Interestingly, all six patients infected by hepatitis C virus genotype 4 or 5 had cryoglobulins.
In patients with hepatitis C virus infection, cryoglobulinemia is not strongly associated with a particular HCV genotype or subtype. The mechanism by which cryoglobulins are produced remains to be elucidated.
背景/目的：近期报告显示，冷球蛋白血症患者中抗丙型肝炎病毒抗体的频率较高。丙型肝炎病毒感染患者中冷球蛋白产生所涉及的因素尚不清楚。为了评估丙型肝炎病毒基因型在混合性冷球蛋白血症发病机制中的作用，我们根据冷球蛋白的有无，分析了118例丙型肝炎病毒感染患者中它们的流行情况。
使用线性探针分析（LiPA，Innogenetics公司）对最常见的基因型（1a、1b、2a、2b、3、4或5）进行丙型肝炎病毒基因组分型。
60例（51%）患者被诊断为冷球蛋白血症，其中33例（55%）为II型冷球蛋白，27例（45%）为III型冷球蛋白。44例（37%）患者无冷球蛋白血症，14例（12%）患者有短暂性冷球蛋白。1a基因型感染患者中冷球蛋白的流行率明显较低。我们发现丙型肝炎病毒基因型与有症状冷球蛋白血症的存在之间没有统计学联系，也没有发现丙型肝炎病毒基因型与冷球蛋白类型（II型或III型）之间的统计学联系。有趣的是，所有6例感染丙型肝炎病毒4型或5型的患者都有冷球蛋白。
在丙型肝炎病毒感染患者中，冷球蛋白血症与特定的HCV基因型或亚型没有强烈关联。冷球蛋白产生的机制仍有待阐明。
