Aim: To study incidence, special features and mechanisms underlying onset of extrahepatic lesions in HCV-infection.
Materials and methods: Extrahepatic symptoms of chronic hepatitis C and its outcome--hepatic cirrhosis were studied in 157 patients. HCV-infection was confirmed by ELISA II and polymerase chain reaction (detection in the serum of anti-HCV and HCVRNA, respectively). Morphological studies of the liver were made in 134 patients, of other organs and tissues--in 20 patients. Immunological tests were made in 124 patients. Thyroid hormones, antibodies to thyroglobuline were measured with radioimmunoassay in 74 patients.
Results: Extrahepatic manifestations were found in 70(44.6%) patients with chronic hepatitis C (more frequently in hepatic cirrhosis), for the most part in women and in long-lasting disease. 54(43.5%) women had cryoglobulinemia, 27 of them showed it clinically. Patients with cryoglobulinemia and free of it exhibited varying frequency cutaneous vasculitis, Raynaud's syndrome, affection of the muscles and joints, nodular periartheritis, lesions of the lungs, myocarditis, autoimmune thyroiditis, Sjogren's syndrome, lichen ruber planus, porphyria cutanea tarda, immune cytopenia, autoimmune hemolytic anemia, hypoplastic anemia, monoclonal immunoglobulinopathy, B-cell lymphoma. Of high frequency were activity of rheumatic factor (66.9%), hypocomplementemia (31.8%), antinuclear antibodies (9.8%) and other immunological disorders.
Conclusion: Some extrahepatic lesions in HCV-infection are detailed: frequent mixed cryoglobulinemia and associated vasculitides of different sites, malignant lymphoproliferative diseases, more frequent than in HBV-infection involvement of the thyroid and salivary glands, some skin lesions.