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Abstract：
BACKGROUND: Persistent cryoglobulinemia after the completion of antiviral treatment is an important consideration of clinical management in chronic hepatitis C patients. We aimed to investigate the occurrence of serum cryoglobulinemia in chronic hepatitis C patients without cryoglobulinemia at the initiation of antiviral treatment.
METHODS: In total, 776 patients without cryoglobulinemia were assessed for serum cryoglobulinemia after the completion of anti-HCV treatment. Serum cryoglobulinemia precipitation was assessed upon both the initiation and the completion of the treatment and analyzed for the clinical laboratory factors associated with chronic hepatitis C.
RESULTS: One hundred eighteen (118) patients were checked for serum cryo-precipitation after the completion of the treatment, and eight patients (4.6%) were positive for serum cryoglobulinemia. The patients who tested positive for cryoglobulinemia included a higher proportion of liver cirrhosis patients (4/50%, p = 0.033) and other organ cancer patients (5/62.5%, p = 0.006) than patients who showed no signs of cryoglobulinemia after treatment. In a multivariate analysis, liver cirrhosis (odds ratio [OR]-17.86, 95% confidence interval [95% CI]-1.79-177.35, p = 0.014) and other organ cancer (OR-25.17 95% CI-2.59-244.23, p = 0.005) were independently and significantly associated with positive cryoglobulinemia 3 months after antiviral treatment.
CONCLUSIONS: Three months after the antiviral DAA therapy had concluded, eight patients tested positive for cryoglobulinemia, representing a 6.7% prevalence. Liver cirrhosis and other organ cancer were independently and significantly associated with positive cryoglobulinemia after antiviral treatment. Further investigation into the causes of positive cryoglobulinemia after DAA antiviral therapy is warranted.
METHODS: In total, 776 patients without cryoglobulinemia were assessed for serum cryoglobulinemia after the completion of anti-HCV treatment. Serum cryoglobulinemia precipitation was assessed upon both the initiation and the completion of the treatment and analyzed for the clinical laboratory factors associated with chronic hepatitis C.
RESULTS: One hundred eighteen (118) patients were checked for serum cryo-precipitation after the completion of the treatment, and eight patients (4.6%) were positive for serum cryoglobulinemia. The patients who tested positive for cryoglobulinemia included a higher proportion of liver cirrhosis patients (4/50%, p = 0.033) and other organ cancer patients (5/62.5%, p = 0.006) than patients who showed no signs of cryoglobulinemia after treatment. In a multivariate analysis, liver cirrhosis (odds ratio [OR]-17.86, 95% confidence interval [95% CI]-1.79-177.35, p = 0.014) and other organ cancer (OR-25.17 95% CI-2.59-244.23, p = 0.005) were independently and significantly associated with positive cryoglobulinemia 3 months after antiviral treatment.
CONCLUSIONS: Three months after the antiviral DAA therapy had concluded, eight patients tested positive for cryoglobulinemia, representing a 6.7% prevalence. Liver cirrhosis and other organ cancer were independently and significantly associated with positive cryoglobulinemia after antiviral treatment. Further investigation into the causes of positive cryoglobulinemia after DAA antiviral therapy is warranted.
摘要：
背景：完成抗病毒治疗后的持续冷球蛋白血症是慢性丙型肝炎患者临床管理的重要考虑因素。我们旨在调查在开始抗病毒治疗时无冷球蛋白血症的慢性丙型肝炎患者血清冷球蛋白血症的发生。
方法：总共，776例无冷球蛋白血症的患者在完成抗HCV治疗后评估血清冷球蛋白血症。在治疗开始和完成时评估血清冷球蛋白血症沉淀，并分析与慢性丙型肝炎相关的临床实验室因素。
结果：118名患者在治疗完成后检查血清低温沉淀，8例(4.6%)血清冷球蛋白血症阳性。冷球蛋白血症检测阳性的患者包括较高比例的肝硬化患者(4/50%,p=0.033）和其他器官癌症患者（5/62.5%，p=0.006）比治疗后无冷球蛋白血症迹象的患者。在多变量分析中，肝硬化(比值比[OR]-17.86,95%置信区间[95%CI]-1.79-177.35,p=0.014)和其他器官癌(OR-25.1795%CI-2.59-244.23,p=0.005)在抗病毒治疗后3个月与冷球蛋白血症阳性独立且显著相关.
结论：抗病毒DAA治疗结束后三个月，8名患者冷球蛋白血症检测呈阳性,代表6.7%的患病率。抗病毒治疗后，肝硬化和其他器官癌与冷球蛋白血症阳性独立且显着相关。进一步研究DAA抗病毒治疗后冷球蛋白血症阳性的原因是必要的。
方法：总共，776例无冷球蛋白血症的患者在完成抗HCV治疗后评估血清冷球蛋白血症。在治疗开始和完成时评估血清冷球蛋白血症沉淀，并分析与慢性丙型肝炎相关的临床实验室因素。
结果：118名患者在治疗完成后检查血清低温沉淀，8例(4.6%)血清冷球蛋白血症阳性。冷球蛋白血症检测阳性的患者包括较高比例的肝硬化患者(4/50%,p=0.033）和其他器官癌症患者（5/62.5%，p=0.006）比治疗后无冷球蛋白血症迹象的患者。在多变量分析中，肝硬化(比值比[OR]-17.86,95%置信区间[95%CI]-1.79-177.35,p=0.014)和其他器官癌(OR-25.1795%CI-2.59-244.23,p=0.005)在抗病毒治疗后3个月与冷球蛋白血症阳性独立且显著相关.
结论：抗病毒DAA治疗结束后三个月，8名患者冷球蛋白血症检测呈阳性,代表6.7%的患病率。抗病毒治疗后，肝硬化和其他器官癌与冷球蛋白血症阳性独立且显着相关。进一步研究DAA抗病毒治疗后冷球蛋白血症阳性的原因是必要的。
