Clinical and diagnostic aspects of mixed cryoglobulinemia in patients with chronic viral hepatitis C

Abstract

Objective: to study the frequency and clinical manifestations of cryoglobulinemia in a population of patients with chronic hepatitis C at different stages of fibrosis. Materials and methods: The source population is 23492 patients with HCV who are registered at the dispensary according to the Register of the Chelyabinsk region. The studied population was randomly formed - 100 patients with verified HCV. As part of the ongoing single-stage clinical study, standard general clinical and biochemical studies (bilirubin, ALT, AST, GGT), HCV RNA in blood with subsequent genotyping of the virus, qualitative and quantitative analysis for serum cryoglobulins (cryocrite level), instrumental methods of research (ultrasound, transient liver elastometry with determination of the degree of fibrosis on the METAVIR scale) were performed for each patient. Results: Cryoglobulins were found in the blood of 63 patients (63%). At the same time, with stage 4 fibrosis in 14 (22%), with stage 3 in 8 (13%), with stage 2 in 1 (1.5%), with grade 1-17 (27%), with stage 0-23 patients (36.5%). Of the total number of patients, only 22 (35%) had complaints and clinical manifestations of cryoglobulinemia. In the vast majority of cases, hemorrhagic purpura was recorded - 18 (28.5%), volatile arthralgia - 4 (6.5%). Clinical manifestations of mixed cryoglobulinemia were observed in 35% of patients with HCV (hemorrhagic purpura, arthralgia). A reliable correlation was obtained between the level of cryocrit and the female sex with a pair correlation coefficient of 0.237 (p<0.05). Conclusion: The data obtained indicate the need for constant monitoring of the frequency of mixed cryoglobulinemia in patients with HCV, early etiotropic therapy with direct antiviral drugs