CLINICAL, BIOCHEMICAL, AND HISTOLOGICAL-CHANGES IN HEPATITIS-C VIRUS INFECTION-ASSOCIATED CRYOGLOBULINEMIA

The most common extrahepatic manifestation of HCV infection is mixed c ryoglobulinemia (MC). 62 unselected patients with chronic HCV infectio n were prospectively evaluated for the presence of cryoglobulinemia an d associated clinical and biochemical parameters. Furthermore, a putat ive relationship between the HCV genotypes and cryoglobulinemia was te sted, Histological features typical for HCV infection were comparative ly analyzed in cases with and without cryoglobulinemia, Whether an int rahepatic Th2-response is responsible for the strong antibody producti on causing cryoglobulinemia was also examined. Cryoglobulins were dete cted in sera of 30 patients (congruent to 48%). Patients with cryoglob ulinemia were on the average elder, showed an apparent longer duration of infection, and suffered more frequently from arthralgia, accompani ed by a significant increase of total serum IgM concentration and rheu matoid factor activity. The HCV genotype distribution among patients w ith cryoglobulinemia was not different from that found in patients wit hout cryoglobulinemia. In cases with cryoglobulinemia, an increased ac tivity of chronic hepatitis and a higher grade of liver fibrosis was n oted, The prevalence of HCV-typical histological lesions among all pat ients were: Portal lymphocytic aggregates (40%), bile duct damage (35% ), steatosis (47%), and intracellular acidophilic bodies (29%). A sign ificant correlation, however, could not be found between cryoglobuline mia and the presence of HCV-typical histological lesions, An intrahepa tic Th2-response causing an increased antibody production could not be observed in cases with cryoglobulinemia.