Parvovirus B19 infection, hepatitis C virus infection, and mixed cryoglobulinaemia
- Patrice Cacouba,
- Narjis Bouklid,
- Pierre Hausfatera,
- Antoine Garbarg-Chenond,
- Pascale Ghillanib,
- Vincent Thibaultc,
- Lucile Mussetb,
- Jean Marie Hurauxc,
- Jean-Charles Piettea
- aDepartment of Internal Medicine, bImmunochemistry Laboratory, cBacteriology and Virology Laboratory, dHôpital La Pitié-Salpétrière, Paris, France Virology Laboratory, Hopital Trousseau, Paris, France
- Professor P Cacoub, Department of Internal Medicine, Hôpital La Pitié-Salpêtrière, 83, Boulevard de l’Hôpital, 75651 Paris Cedex 13, France.
- Accepted 8 June 1998
Abstract
BACKGROUND Infection with human parvovirus B19 (B19) has been reported in a few patients with various vasculitis syndromes. Mixed cryoglobulinaemia (MC), a model of small vessel size vasculitis, may result from numerous infectious diseases, particularly hepatitis C virus (HCV) infection.
AIM To assess the prevalence of seric B19 infection markers in a large series of patients with MC, with or without HCV infection.
PATIENTS AND METHODS Sixty four patients were studied: essential MC (EMC, n = 19), MC associated with non-infectious diseases (non-essential MC, n = 9), and patients with HCV infection with (HCV-MC, n = 18) or without MC (HCV-no-MC, n = 18). Patients were considered to have MC if two successive determinations of their serum cryoglobulin concentration were above 0.05 g/l. Serum samples were analysed for specific IgG and IgM antibodies to B19 by enzyme immunoassay. B19 DNA detection was performed by polymerase chain reaction using a set of primers located in the VP1 gene, separately in serum and in cryoprecipitates to investigate a possible capture of B19 DNA in cryoprecipitate. The study also looked for a possible enrichment for of IgG antibodies to B19 in MC.
RESULTS The presence of specific IgG antibodies to B19 was found in 68% EMC, 56% non-essential MC, 78% HCV-MC, and 78% HCV-no-MC. No patient of either group had specific IgM antibodies to B19, or B19 DNA in serum or in cryoprecipitate. Overall, IgG antibodies to B19 were found in 46 of 64 (72%) serum samples, a prevalence quite similar to the prevalence in general adult population (> 60 %). A specific enrichment of IgG antibodies to B19 in the MC was not found.
CONCLUSION These results suggest that B19 infection is neither an aetiological factor of EMC, nor a cofactor that may lead to MC production in patients with chronic HCV infection.
