Cacoub P, Boukli N, Hausfater P, Garbarg-Chenon A, Ghillani P, Thibault V, Musset L, Huraux J M, Piette J C
Department of Internal Medicine, Hôpital La Pitié-Salpétrière, Paris, France.
Ann Rheum Dis. 1998 Jul;57(7):422-4. doi: 10.1136/ard.57.7.422.
Infection with human parvovirus B19 (B19) has been reported in a few patients with various vasculitis syndromes. Mixed cryoglobulinaemia (MC), a model of small vessel size vasculitis, may result from numerous infectious diseases, particularly hepatitis C virus (HCV) infection.
To assess the prevalence of seric B19 infection markers in a large series of patients with MC, with or without HCV infection.
Sixty-four patients were studied: essential MC (EMC, n = 19), MC associated with non-infectious diseases (non-essential MC, n = 9), and patients with HCV infection with (HCV-MC, n = 18) or without MC (HCV-no-MC, n = 18). Patients were considered to have MC if two successive determinations of their serum cryoglobulin concentration were above 0.05 g/l. Serum samples were analysed for specific IgG and IgM antibodies to B19 by enzyme immunoassay. B19 DNA detection was performed by polymerase chain reaction using a set of primers located in the VP1 gene, separately in serum and in cryoprecipitates to investigate a possible capture of B19 DNA in cryoprecipitate. The study also looked for a possible enrichment for of IgG antibodies to B19 in MC.
The presence of specific IgG antibodies to B19 was found in 68% EMC, 56% non-essential MC, 78% HCV-MC, and 78% HCV-no-MC. No patient of either group had specific IgM antibodies to B19, or B19 DNA in serum or in cryoprecipitate. Overall, IgG antibodies to B19 were found in 46 of 64 (72%) serum samples, a prevalence quite similar to the prevalence in general adult population (> 60%). A specific enrichment of IgG antibodies to B19 in the MC was not found.
These results suggest that B19 infection is neither an aetiological factor of EMC, nor a cofactor that may lead to MC production in patients with chronic HCV infection.
已有少数患有各种血管炎综合征的患者被报道感染人细小病毒B19（B19）。混合性冷球蛋白血症（MC）是一种小血管大小的血管炎模型，可能由多种传染病引起，尤其是丙型肝炎病毒（HCV）感染。
评估一大组有或无HCV感染的MC患者中血清B19感染标志物的患病率。
研究了64例患者：原发性MC（EMC，n = 19）、与非感染性疾病相关的MC（非原发性MC，n = 9），以及有（HCV-MC，n = 18）或无MC（HCV-无-MC，n = 18）的HCV感染患者。如果连续两次测定血清冷球蛋白浓度高于0.05 g/l，则患者被认为患有MC。通过酶免疫测定分析血清样本中针对B19的特异性IgG和IgM抗体。使用位于VP1基因中的一组引物通过聚合酶链反应进行B19 DNA检测，分别在血清和冷沉淀物中进行，以研究冷沉淀物中可能捕获的B19 DNA。该研究还寻找了MC中针对B19的IgG抗体可能的富集情况。
在68%的EMC、56%的非原发性MC、78%的HCV-MC和78%的HCV-无-MC中发现了针对B19的特异性IgG抗体。两组患者均无针对B19的特异性IgM抗体，血清或冷沉淀物中也无B19 DNA。总体而言，64份血清样本中有46份（72%）发现了针对B19的IgG抗体，这一患病率与一般成年人群（>60%）的患病率相当。未发现MC中针对B19的IgG抗体有特异性富集。
这些结果表明，B19感染既不是EMC的病因，也不是慢性HCV感染患者中可能导致MC产生的辅助因素。
