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Gut 1999;45:122-128 doi:10.1136/gut.45.1.122
  • Liver disease

Response to interferon α treatment and disappearance of cryoglobulinaemia in patients infected by hepatitis C virus

  1. P Crestaa,
  2. L Mussetb,
  3. P Cacoubc,
  4. L Frangeuld,
  5. D Vitoura,
  6. T Poynarde,
  7. P Opolone,
  8. D-T Nguyenf,
  9. F Golliotf,
  10. J-C Piettec,
  11. J-M Hurauxd,
  12. F Lunela
  1. aLaboratoire de Bactério-Virologie, CHU Angers, Angers, France, bService d’Immunochimie, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris Cedex 13, France, cService de Médecine Interne, dLaboratoire de Bactério-Virologie, eService d’Hépato- Gastroentérologie, fService de Santé Publique
  1. Professor F Lunel, Service de Bactério-Virologie, CHU Angers, 4 rue Larrey, 49033 Angers Cedex, France.
  • Accepted 25 January 1999

Abstract

BACKGROUND Mixed cryoglobulinaemia is closely associated with hepatitis C virus (HCV) infection.

AIM To assess in a prospective open study the efficiency of interferon α treatment of cryoglobulinaemia, as reflected by the disappearance of cryoglobulins and clinical manifestations of the disease, and to analyse the factors predictive of a response to interferon.

METHOD Eighty seven consecutive patients with chronic hepatitis C treated for the first time with interferon at a dose of 3 × 106 international units three times a week for six months were studied. Forty three patients had cryoglobulins, which were responsible for clinical manifestations in 12.

RESULTS At the end of interferon treatment, cryoglobulins had disappeared in 39% of the patients. A clinical improvement (except for neuropathies) was observed in all patients. Six months after interferon treatment was stopped, the same rate of response (normal alanine aminotransferase values and undectable HCV RNA) was observed in patients with or without cryoglobulins. Only 14% of patients still had undetectable cryoglobulins, and all of them also had undetectable serum HCV RNA. The disappearance of cryoglobulins was found less frequently in patients with clinical symptoms than in asymptomatic ones, but the difference was not significant. Sustained responders were more often men, infected by genotype 2 or 3, with a lower pretreatment viral load.

CONCLUSION The presence of cryoglobulins does not seem to affect the response to interferon in HCV infected patients. The improvement in cryoglobulinaemia is strongly associated with a virological response, reinforcing the hypothesis of a direct role for HCV in the pathogenesis of this disease.

Footnotes

  • Abbreviations used in this paper:
    HCV
    hepatitis C virus
    ALT
    alanine aminotransferase
    RT
    reverse transcription
    PCR
    polymerase chain reaction

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