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

Jean-Michel Pawlotsky, MD; Francoise Roudot-Thoraval, MD; Peter Simmonds, PhD; Janet Mellor, PhD; Mustapha Ben Yahia, MD; Chantal Andre, MD; Marie-Catherine Voisin, MD; Liliane Intrator, MD; Elie-Serge Zafrani, MD; Jean Duval, MD; and Daniel Dhumeaux, MD
[+] Article and Author Information

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.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;122(3):169-173. doi:10.7326/0003-4819-122-3-199502010-00002
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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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