SERUM CRYOGLOBULIN AND CHRONIC HEPATITIS-C VIRUS-DISEASE AMONG JAPANESE PATIENTS

Hepatitis C virus (HCV)-associated mixed cryoglobulins appear to be de tected often in hepatitis C-related chronic liver disease. The associa tion of the two phenomenon among Japanese patients is the subject of t he present study. Methods: Serum levels of total hemolytic complement (CH50) and anti-C3d-binding immune complex, as well as the prevalence of cryoglobulins, were studied in 213 patients with chronic liver dise ase (hepatitis C, 155; hepatitis B, 58). Cryoprecipitates were tested for anti-HCV Ab and HCV RNA. Results: CH50 activity was significantly lower in patients with hepatitis C than in those with hepatitis B exce pt in responders to interferon who showed a sustained loss of HCV RNA. Cryoglobulins were detected in 24 (37%) of 65 patients with hepatitis C; they generally consisted of polyclonal immunoglobulins but one cas e. Cryoglobulins were more frequently observed in cirrhotic patients a nd in those with a longer duration of disease. Cryoglobulinemia-relate d clinical signs such as vasculitis occurred in only three cases. Pati ents with cryoglobulins had lower CH50 activity and higher immune comp lex values than those without cryoglobulins. Anti-HCV Ab and HCV RNA w ere detected in all cryoprecipitates tested. Conclusions: These findin gs suggest that HCV is a major cause of cryoglobulins and advanced liv er damage. However, serum cryoglobulins with polyclonal immunoglobulin s appear to be less frequent among Japanese patients than among those studied in Western countries.