Cryoglobulinemia Related to Hepatitis C Virus Infection

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2007 Mar 24

PMID 17380399

Citations 16

Authors

Maria Pina Dore

Giovanna Fattovich

Antonia R Sepulveda

Giuseppe Realdi

Affiliations

Soon will be listed here.

Abstract

A causal link among hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia, cryoglobulinemic glomerulonephritis, and vasculitis is strongly supported. HCV triggers autoimmune response in predisposed individuals that manifests as organ-specific and non-organ-specific autoantibodies and as polyclonal/monoclonal rheumatoid factor, which has a central role in causing damaging cryoglobulin and immune complex tissue levels. Immunologic events are mainly induced by HCV infection persistence, with excessive immune stimulation. Humoral immune dysfunction leads to autoantibodies and rheumatoid factor production with cryoglobulinemia, glomerulonephritis, vasculitis, neuropathy, and probably thyroiditis, and arthritis in rare cases. Cellular immune dysfunction leads to lymphocytic infiltration, proliferation, and cytokine production. Pegylated (or not) interferon-alpha in combination with ribavirin appears to be the treatment of choice for patients with symptomatic essential mixed cryoglobulinemia with or without glomerulonephritis. Novel treatment with rituximab is promising.

Citing Articles

Sustained virological response to hepatitis C therapy does not decrease the incidence of systemic lupus erythematosus or rheumatoid arthritis.

Hsu W, Chen C, Tseng K, Lai H, Kuo H, Hung C Sci Rep. 2020; 10(1):5372.

PMID: 32214132 PMC: 7096452. DOI: 10.1038/s41598-020-61991-3.

Recovery of hepatitis C specific T-cell responses after rituximab therapy in hepatitis C mixed cryoglobulinemic vasculitis.

Mathur P, Emmanuel B, Sneller M, Zhang X, Poonia B, Kottilil S J Med Virol. 2017; 90(5):936-941.

PMID: 29236302 PMC: 5849501. DOI: 10.1002/jmv.25002.

Transcriptional profiling of PBMCs unravels B cell mediated immunopathogenic imprints of HCV vasculitis.

Comstock E, Kim C, Murphy A, Emmanuel B, Zhang X, Sneller M PLoS One. 2017; 12(12):e0188314.

PMID: 29228031 PMC: 5724854. DOI: 10.1371/journal.pone.0188314.

[Viral arthritis and vasculitis].

Sixdorf U, Marker-Hermann E Z Rheumatol. 2016; 75(9):878-884.

PMID: 27761646 DOI: 10.1007/s00393-016-0213-0.

Decline of cellular activation in non-B cells after rituximab treatment in hepatitis C-associated mixed cryoglobulinemia vasculitis.

Emmanuel B, Sidique N, Zhang X, Poonia B, Sneller M, Kottilil S J Viral Hepat. 2016; 24(2):128-131.

PMID: 27666584 PMC: 5733781. DOI: 10.1111/jvh.12618.

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