Mixed Cryoglobulinemia in HIV-1 Infection: The Role of HIV-1
- Antonios N. Dimitrakopoulos, MD;
- Theodore Kordossis, MD;
- Angelos Hatzakis, MD; and
- Haralampos M. Moutsopoulos, MD
Abstract
Background: Cryoglobulins are associated with chronic infections.
Objective: To investigate the prevalence of mixed cryoglobulinemia in patients with HIV-1 infection, the clinical spectrum of cryoglobulinemia in these patients, and the possible role of HIV-1 in cryoglobulin formation.
Design: Prospective cohort study.
Setting: Laiko Hospital, Athens, Greece.
Patients: 89 patients with HIV-1 infection.
Measurements: Serum and cryoglobulins were evaluated for antibodies to HIV and hepatitis C virus (HCV), HIV-1, and HCV viral load.
Results: Mixed cryoglobulins were detected in 24 patients with HIV-1 infection (27% [95% CI, 18% to 36%]). The HIV-1 viral load was higher in cryoglobulin-positive patients (median, 38.25 × 103 copies/mL [25th, 75th percentiles: 13.8 × 103 copies/mL, 78.55 × 103 copies/mL]) than in cryoglobulin-negative patients (median, 5.3 × 103 copies/mL [25th, 75th percentiles: 0.7 × 103 copies/mL, 27.2 × 103 copies/mL]) (P = 0.001). Antibodies to HIV were detected in all cryoprecipitates, and HIV-1 RNA sequences were identified in 22 of the 23 cryoprecipitates examined. Nine cryoglobulin-positive patients (38% [CI, 19% to 54%]) had clinical manifestations compatible with cryoglobulinemia.
Conclusions: Mixed cryoglobulinemia is common in patients with HIV-1 infection.
- Human immunodeficiency virus-1
- Human immunodeficiency virus infections
- Cryoglobulinemia
- Cryoglobulins
- Comorbidity
Article and Author Information
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Acknowledgments: The authors thank Fani Giannoula and Anna Gialeraki for technical assistance and Urania Dafni for statistical assistance.
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Grant Support: In part by grants 19/9.7.97 and 21/1.8.97 from Laiko General Hospital, Athens, Greece.
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Requests for Reprints: Haralampos M. Moutsopoulos, MD, Department of Pathophysiology, Medical School, National and Kapodistrian University, 75 Mikras Asias Street, 11527, Athens, Greece.
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Current Author Addresses: Drs. Dimitrakopoulos, Kordossis, and Moutsopoulos: Department of Pathophysiology, Medical School, National and Kapodistrian University, 75 Mikras Asias Street, 11527, Athens, Greece.
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Dr. Hatzakis: Department of Hygiene and Epidemiology, Medical School, National and Kapodistrian University, 75 Mikras Asias Street, 11527, Athens, Greece.
- Copyright ©2004 by the American College of Physicians
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