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Hepatitis C virus chronic infection as a common cause of mixed cryoglobulinaemia and autoimmune liver disease.

Abstract：

OBJECTIVES:Mixed cryoglobulinaemia (MC) and autoimmune chronic hepatitis (AI-CH) are frequently associated with hepatitis C virus (HCV) chronic infection. Because HCV represents a possible common aetiological factor, the aim of the present study is to investigate the clinico-serological alterations of both MC and AI-CH and to verify a possible overlap between these disorders. SETTING:Patients from three tertiary referral centres. SUBJECTS:Two Italian series of 88 MC patients and 30 AI-CH type 1 were studied. RESULTS:MC and AI-CH share several clinico-serological features. The patients' mean age (MC vs. AI-CH: 60 +/- 9 vs. 57 +/- 13 years), disease duration (10.5 +/- 5 vs. 9.6 +/- 6 years), and female/male ratio (3.4 vs. 3.3) were very similar in the two series. Typical hallmarks of MC, i.e. purpura, arthralgias, and weakness, circulating mixed cryoglobulins with rheumatoid factor activity, and hypocomplementemia were also recorded in a significant number of AI-CH patients. Similarly, chronic active hepatitis was found in 68% of MC patients and its histological and serological alterations were comparable with those of AI-CH; moreover, amongst various autoantibodies, antinuclear antibodies and/or anti-smooth-muscle antibodies were detected in half of the cases of MC. Anti-HCV antibodies, detected by second-generation Chiron ELISA and RIBA, were present in a high percentage of both MC and AI-CH (94 vs. 80%), and frequently associated with HCV viraemia (86 vs. 77%). Finally, anti-GOR, the HCV-related autoantibodies, were found in half cases of MC and AI-CH. CONCLUSIONS:On the whole, these data suggest that HCV in combination with other infectious and environmental and genetic factors can trigger a complex immunological disorder with different clinical patterns.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Ferri C,Longombardo G,La Civita L,Greco F,Lombardini F,Cecchetti R,Cagianelli MA,Marchi S,Monti M,Zignego AL

doi

10.1111/j.1365-2796.1994.tb01116.x

subject

Has Abstract,Author List Incomplete

pub_date

1994-07-01 00:00:00

pages

31-6

issue

eissn

0954-6820

issn

1365-2796

journal_volume

236

pub_type

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Hepatitis C virus chronic infection as a common cause of mixed cryoglobulinaemia and autoimmune liver disease.