EXTRAHEPATIC IMMUNOLOGICAL MANIFESTATIONS IN CHRONIC HEPATITIS-C AND HEPATITIS-C VIRUS SEROTYPES

Objective: To determine, using a serotyping assay, whether the occurre nce of extrahepatic immunologic disorders in patients with chronic hep atitis C is dependent on hepatitis C virus serotype. II Design: Prospe ctive study. Setting: Liver unit and virology laboratory of a universi ty hospital. Patients: 59 consecutive patients with chronic hepatitis C. Measurements: Hepatitis C virus serotype was determined using a rec ently developed immunoenzymatic assay that detects antibodies directed to serotype-specific immunodominant epitopes. Cryoglobulin, rheumatoi d factor, and numerous antitissue antibodies were sought. Biopsies of labial salivary glands were done in 49 of the 59 patients. Results: Pr evalence was 59% for serotype 1, 10% for serotype 2, 12% for serotype 3, and 3% for mixed infection. Fifteen percent of patients could not b e serotyped. Cryoglobulinemia was found in 36% of patients and rheumat oid factor was found in the serum of 71%. At least one antitissue anti body was found in the serum of 41% of patients; salivary gland biopsy showed lymphocytic capillaritis in 49% of patients. These immunologic abnormalities were seen in patients infected with any of the three ser otypes, and prevalences of the abnormalities did not differ significan tly among patients infected with different serotypes.Conclusions: We c onfirm that the prevalence of extrahepatic immunologic abnormalities i s high in patients with chronic hepatitis C. These abnormalities may o ccur in patients infected with any of the three major hepatitis C viru s serotypes now present in developed countries.