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Cholestatic HCV Cryoglobulinemia: A New Clinical and Pathological Entity before and after Direct-Acting Antiviral Therapies-A Case-Control Study.
Ammendola, Serena; Romeo, Sara; Cattazzo, Filippo; Mantovani, Anna; Ieluzzi, Donatella; Paon, Veronica; Montagnana, Martina; Pecori, Sara; Tomezzoli, Anna; Dalbeni, Andrea; Sacerdoti, David.
Afiliación
  • Ammendola S; Division of Pathology, Department of Diagnostics and Public Health, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Romeo S; Division of General Medicine C, Department of Medicine, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Cattazzo F; Liver Unit, Department of Medicine, University of Verona, 37129 Verona, Italy.
  • Mantovani A; Division of General Medicine C, Department of Medicine, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Ieluzzi D; Liver Unit, Department of Medicine, University of Verona, 37129 Verona, Italy.
  • Paon V; Division of General Medicine C, Department of Medicine, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Montagnana M; Liver Unit, Department of Medicine, University of Verona, 37129 Verona, Italy.
  • Pecori S; Division of General Medicine C, Department of Medicine, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Tomezzoli A; Liver Unit, Department of Medicine, University of Verona, 37129 Verona, Italy.
  • Dalbeni A; Division of General Medicine C, Department of Medicine, Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
  • Sacerdoti D; Liver Unit, Department of Medicine, University of Verona, 37129 Verona, Italy.
Int J Mol Sci ; 25(2)2024 Jan 08.
Article en En | MEDLINE | ID: mdl-38255857
ABSTRACT
Twenty-nine patients with HCV infection (HCV+) and mixed cryoglobulinemia (MC+) were retrospectively selected and matched for age and sex with 31 HCV+ MC- patients. Biomarkers of cholestasis (direct bilirubin, alkaline phosphatase, and gamma-glutamyl transferase), HCV-RNA and genotype, and plasma cryoprecipitates were measured before and after virus eradication; liver histology and plasma cells (aggregation and distribution), observed blinded by two pathologists, were analyzed. Sixty participants (mean age 56.5; range 35-77, males 50%) with HCV infection were enrolled. Cholestasis (≥2 pathologically increased cholestasis biomarkers) was significantly higher in the MC group (p = 0.02) and correlated with cryoglobulinemia (OR 6.52; p = 0.02). At liver histological assessment, plasma cells were significantly increased in the MC+ group (p = 0.004) and tended to form aggregates more than the control group (p = 0.05). At multivariate analysis with MC, age, HCV-RNA, HBV diabetes, and cirrhosis, cholestasis was only significantly correlated to MC (OR 8.30; p < 0.05). In 25% patients, MC persisted after virus eradication with new antiviral treatment. Our study identified for the first time an association between MC, cholestasis, and an increased number of intrahepatic plasma cells in chronic hepatitis C (CHC) patients before virus eradication. Future studies are required to understand how MC contributes to liver damage and how its persistence affects the patients' follow-up after antiviral therapies.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Colestasis / Hepatitis C / Hepatitis C Crónica / Crioglobulinemia Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Colestasis / Hepatitis C / Hepatitis C Crónica / Crioglobulinemia Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Italia