Extrahepatic Immunologic Manifestations in Chronic Hepatitis C and Hepatitis C Virus Serotypes

  1. Jean-Michel Pawlotsky, MD;
  2. Francoise Roudot-Thoraval, MD;
  3. Peter Simmonds, PhD;
  4. Janet Mellor, PhD;
  5. Mustapha Ben Yahia, MD;
  6. Chantal Andre, MD;
  7. Marie-Catherine Voisin, MD;
  8. Liliane Intrator, MD;
  9. Elie-Serge Zafrani, MD;
  10. Jean Duval, MD; and
  11. Daniel Dhumeaux, MD
  1. From the Universite de Paris XII, Creteil, France; and the University of Edinburgh, Edinburgh, United Kingdom. Requests for Reprints: Jean-Michel Pawlotsky, MD, Service de Bacteriologie-Virologie, Hopital Henri Mondor, F-94010 Creteil Cedex, France.

    Abstract

    Objective: To determine, using a serotyping assay, whether the occurrence of extrahepatic immunologic disorders in patients with chronic hepatitis C is dependent on hepatitis C virus serotype.

    Design: Prospective study.

    Setting: Liver unit and virology laboratory of a university hospital.

    Patients: 59 consecutive patients with chronic hepatitis C.

    Measurements: Hepatitis C virus serotype was determined using a recently developed immunoenzymatic assay that detects antibodies directed to serotype-specific immunodominant epitopes. Cryoglobulin, rheumatoid factor, and numerous antitissue antibodies were sought. Biopsies of labial salivary glands were done in 49 of the 59 patients.

    Results: Prevalence was 59% for serotype 1, 10% for serotype 2, 12% for serotype 3, and 3% for mixed infection. Fifteen percent of patients could not be serotyped. Cryoglobulinemia was found in 36% of patients and rheumatoid factor was found in the serum of 71%. At least one antitissue antibody was found in the serum of 41% of patients; salivary gland biopsy showed lymphocytic capillaritis in 49% of patients. These immunologic abnormalities were seen in patients infected with any of the three serotypes, and prevalences of the abnormalities did not differ significantly among patients infected with different serotypes.

    Conclusions: We confirm that the prevalence of extrahepatic immunologic abnormalities is high in patients with chronic hepatitis C. These abnormalities may occur in patients infected with any of the three major hepatitis C virus serotypes now present in developed countries.

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    1. Ann Intern Med February 1, 1995 vol. 122 no. 3 169-173
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