Inflammation biomarkers in chronic hepatitis C: association with liver histopathology, HCV genotype and cryoglobulinemia

Atta, Mustafa S.; Cabral, Milena Santana; Santos, G Alarcón; Paraná, Raymundo; Atta, Ajax Mercês

doi:10.1007/s00011-012-0502-2

Cited by 16 publications

(15 citation statements)

References 30 publications

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“…[2][3][4][5][6][7][8][9] Confirming our previous reports, cryoglobulinemia was the main extrahepatic manifestation of HCV infection in Brazilian patients who participated of this study. 16,17 Furthermore, we verified that cryoglobulinemic patients produced more IgA, IgM and both kappa and lambda FLC than did patients without cryoglobulinemia. In cryoglobulinemic individuals, the levels of both kappa and lambda FLC were strongly correlated with the IgA, IgG and IgM levels, suggesting an intense polyclonal production of these immunoglobulins.…”

Section: Discussionsupporting

confidence: 62%

“…14,15 Although we have shown that Brazilian patients with chronic HCV infection present a high prevalence of cryoglobulinemia, no studies have been conducted to investigate markers of B-cell malignancies in these subjects. 16,17 The aim of the present work was to investigate the serum levels of kappa and lambda FLC, the kappa/lambda FLC ratio, and the immunochemical composition of cryoglobulins in Brazilian patients with chronic HCV infection and cryoglobulinemia.…”

Section: Introductionmentioning

confidence: 99%

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Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Oliveira

Cabral

Jesus

et al. 2014

The Brazilian Journal of Infectious Diseases

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Hepatitis C virus (HCV) infects B-lymphocytes, provokes cellular dysfunction and causes lymphoproliferative diseases such as cryoglobulinemia and non-Hodgkin's B-cell lymphoma. In the present study, we investigated the serum levels of kappa and lambda free light chains (FLC) of immunoglobulins and the kappa/lambda FLC ratio in Brazilian patients with chronic HCV infection and cryoglobulinemia. We also analyzed the immunochemical composition of the cryoglobulins in these patients. Twenty-eight cryoglobulinemic HCV patients composed the target group, while 37 HCV patients without cryoglobulinemia were included as controls. The median levels of kappa and lambda FLC were higher in patients with cryoglobulinemia compared to controls (p=0.001 and p=0.003, respectively), but the kappa/lambda FLC ratio was similar in patients with and without cryoglobulinemia (p>0.05). The median FLC ratio was higher in HCV patients presenting with advanced fibrosis of the liver compared to HCV patients without fibrosis (p=0.004). Kappa and lambda FLC levels were strongly correlated with the IgA, IgG and IgM levels in the patients with cryoglobulinemia. In patients without cryoglobulinemia, the kappa FLC level was only correlated with the IgG level, whereas the lambda FLC were weakly correlated with the IgA, IgG and IgM levels. An immunochemical pattern of mixed cryoglobulins (MC), predominantly IgM, IgG, IgA and kappa light chain, was verified in these immune complexes. We concluded that HCV-infected patients presenting cryoglobulinemia have vigorous polyclonal B-lymphocyte activation due to chronic HCV infection and persistent immune stimulation.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Oliveira

Cabral

Jesus

et al. 2014

The Brazilian Journal of Infectious Diseases

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“…In previous studies performed in populations without hemolytic disorders, low serum levels of Hp were reported in HCV infected patients with or without fibrosis compared to non-infected controls 30,31. As far as we know, there are no published data about this relation among population with thalassemia.…”

Section: Discussionmentioning

confidence: 90%

Study of Serum Haptoglobin Level and Its Relation to Erythropoietic Activity in Beta Thalassemia Children .

Ragab

Safan

Badr

2015

Mediterr J Hematol Infect Dis

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BackgroundSerum haptoglobin (Hp) is a reliable marker for hemolysis regardless the inflammatory state.ObjectiveWe investigated the possible relation between Hp depletion and hemolysis severity, hepatitis C virus (HCV) infection and iron load in β-thalassemia children.MethodsTwenty two β-thalassemia major (TM),20 β-thalassemia intermedia (TI) children with 20 age and sex matched healthy controls were involved. Pre-transfusion hemoglobin level was considered. Serum ferritin, Hp and transferrin receptor levels (sTfR) (by ELISA ), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (by colorimetric method) were assayed. Markers of hepatitis C virus (HCV) were done by PCR.ResultsThe mean Hp levels among the studied groups were as follows; 8.02 ± 0.93 (mg/dl), 8.6 ±0.72 (mg/dl) and 122 ± 18.5(mg/dl) for TM, TI and the controls respectively. Both patient groups had significantly lower Hp level compared to the controls (P<0.0001) with significant lower level in TM compared to TI children ( P= 0.034). Significant inverse correlations were found between serum Hp and sTfR levels ( reflecting the erythropoietic activity) in thalassemia children combined and in each group (TM and TI) as well as among HCV infected children. STfR was the only significant independent predictor for serum Hp level (t= −5.585, P<0.0001). Among HCV infected patients, no significant correlation was found between serum Hp and serum transaminases.ConclusionSerum Hp depletion in thalassemia had significant relation to disease severity and correlated well with their erythropoietic activity, as assessed by the measurement of sTfR without significant relation to HCV infection. Extensive multicenter studies are recommended.

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“…CRP is primarily synthesized in the liver and prior studies have shown that patients with HCV and alcoholic liver disease may not be able to generate sufficient quantities of CRP despite ongoing inflammation as evidenced by higher levels of other inflammatory markers, such as interleukin-10 and TNF␣ (29). Lower CRP levels are noted in HCV-positive patients with (30) or without steatohepatitis (31). Therefore, the observation of lower CRP levels among HCV patients in this study might be hypothesized to represent a direct effect of HCV infection on hepatic CRP production in the liver.…”

Section: Discussionmentioning

confidence: 99%

Disease Characteristics and Treatment Patterns in Veterans With Rheumatoid Arthritis and Concomitant Hepatitis C Infection

Patel

Mikuls

Richards

et al. 2015

Arthritis Care & Research

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Objective. To assess disease characteristics, disease activity, and treatment patterns in rheumatoid arthritis (RA) patients with comorbid hepatitis C virus (HCV) infection. Methods. RA patients with concomitant HCV were identified within the Veterans Affairs Rheumatoid Arthritis Registry. HCV was defined as at least 1 diagnostic code present in medical record databases. Generalized estimating equations in linear regression models compared component and composite measures of disease activity between HCV-positive and HCV-negative patients over the study period, accounting for within-subject correlations. Similar analysis of pharmacy databases evaluated medication use within each group. Results. Ninety-two of 1,706 registry participants (5.1%) were identified with concomitant HCV. At enrollment, HCVpositive patients were younger (mean ؎ SD 61.7 ؎ 7.1 years versus 67.5 ؎ 11.2 years; P < 0.001), more often African American (35% versus 15%; P < 0.001), and smokers (48% versus 26%; P < 0.001). In unadjusted and adjusted analyses incorporating all study visits, patient-reported outcomes (pain, tender joints, and patient global scores) were higher in HCV-positive patients, contributing to higher disease activity scores. There was no difference in physician-reported outcomes (swollen joints or physician global scores). HCV-positive patients had lower C-reactive protein levels (␤ ؊0.30 Conclusion. RA patients with concomitant HCV have higher disease activity scores, driven primarily by higher patient-reported measures. HCV-positive patients were more likely to be treated with prednisone and anti-TNF␣ therapies and less likely to receive methotrexate compared to HCV-negative patients.

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Inflammation biomarkers in chronic hepatitis C: association with liver histopathology, HCV genotype and cryoglobulinemia

Abstract: Chronic hepatitis C virus infection alters the levels of some biomarkers, which are mainly observed in patients with liver fibrosis and hepatic necroinflammatory activity.

Cited by 16 publications

References 30 publications

Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Study of Serum Haptoglobin Level and Its Relation to Erythropoietic Activity in Beta Thalassemia Children .

Disease Characteristics and Treatment Patterns in Veterans With Rheumatoid Arthritis and Concomitant Hepatitis C Infection

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