Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background:Estimates of the prevalence of mixed cryoglobulinemia in people with HCV infection vary widely. This is because of unfamiliarity with clinical symptoms, lead-time bias, and mishandling of specimens. The association between cryoglobulinemia and severe liver affection is a controversial issue. The aim of the present work:To determine whether a specific cryoglobulin type, type IIa and not mixed cryoglobulins in general associate with cirrhosis & its progression in patients infected with hepatitis C virus. Patients and methods:The study conducted on 80 patients infected with HCV (with and without cirrhosis). The subjects were divided into two groups: Group 1: 40 Patients infected with hepatitis C and have evidence of liver cirrhosis. Group 2: 40 Patients infected with hepatitis C without cirrhosis. Data was collected for each patient including age, sex, cryoglobulin characterization, serum HCV-RNA concentration, anti-HCV antibodies, and serum alanine transaminase.Univariate analyses were used to compare demographics, clinical and laboratory data. Differences in proportions were examined with the Chi-square test or Fisher{u2019}s exact test. An unpaired T test was used for continuous variables. All calculated P values are 2-tailed and those < 0.05 were noted. Results:the study showedthe prevalence of mixed cryoglobulinstype IIatest,which was positive in 25% of studied population (both groups), and high positive correlation was detected between the cryoglobulins positivity and presence of cirrhosis, as we found that only 5 patients (12.5%) of group 1 (patients with no evidence of cirrhosis), while it was positive in 15 patients (37.5%) of group 2 (patients with evidence of cirrhosis) which made P-value (0.01) highly statistically significant. Also, it was found that HCV- PCR was significantly elevated in group 1(patients without cirrhosis) than in group 2 with statistically significant P-value 0.01.Finally, our studydid not detect any positive correlation between mixed cryoglobulin type IIa positivity and age, sex, or ALT levels

Issued also as CD