Autoimmunity and lymphoproliferation markers in naïve HCV-RNA positive patients without clinical evidences of autoimmune/lymphoproliferative disorders

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• 作者：Francesca Gulli^a ; ¹ ; Umberto Basile^a ; ¹ ; Laura Gragnani^b ; ¹ ; ^{laura.gragnani@unifi.it" class="auth_mail" title="E-mail the corresponding author} ; Elisa Fognani^b ; Cecilia Napodano^a ; Luigi Colacicco^a ; Luca Miele^c ; Nicoletta De Matthaeis^c ; Paola Cattani^d ; Anna Linda Zignego^b ; Gian Ludovico Rapaccini^c
• 关键词：Antinuclear antibodies (ANA) ; Cryoglobulins (CGs) ; Hepatitis C virus (HCV) ; Rheumatoid factor (RF)
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：48
• 期：8
• 页码：927-933
• 全文大小：1694 K

文摘

HCV can lead to both chronic liver disease and B-cell lymphoproliferative disorders. A strong association exists between HCV and mixed cryoglobulinaemia (MC).

Methods

Anti-nuclear antibodies (ANA), rheumatoid factor Ig-G (RF-IgG), free light chain κ and λ (FLC-κ, FLC-λ) levels and κ/λ ratio were evaluated in 50/420 subjects unexpectedly resulted anti-HCV positive after routine screenings for non-hepathological procedures.

Results

Three/fifty patients had HCV-RNA undetectable in the serum and were excluded from the analysis. Thirty-nine/fifty patients had laboratory evidence of circulating cryoglobulins without liver disease and MC-related symptoms. Among them, 17 resulted ANA-positive.

The mean cryocrit was higher in ANA-positive patients, while no other demographic/clinical differences were observed between the groups. Significantly higher levels of RF-IgG were observed in ANA-positive vs ANA-negative patients. κ and λ FLC were higher in ANA-positive patients.

A ROC analysis, based on ANA-positivity vs ANA-negativity, confirmed a high sensitivity and specificity of RF-IgG test.

Conclusions

Published data concerning MC come mostly from symptomatic vasculitis. We analyzed HCV-patients without MC symptoms, founding cryoglobulins in the majority of them.

The increased levels of FR-IgG and FLC in CGs-ANA-positive patients, suggest these test could be used to identify a state of silent autoimmune and/or lymphoproliferative condition before the transition to a frank disease in naïve HCV-patients without symptoms of extrahepatic manifestations.