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Mixed cryoglobulinemia is associated with increased risk for death, or neoplasia in HIV‐1 infection
Author(s) -
Kordossis T.,
Sipsas N. V.,
Kontos A.,
Dafni U.,
Moutsopoulos H. M.
Publication year - 2001
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2001.00934.x
Subject(s) - cryoglobulinemia , medicine , lymphoproliferative disorders , gastroenterology , risk factor , lymphoma , cryoglobulins , immunology , relative risk , hepatitis c virus , hepatitis c , pathology , confidence interval , virus , antibody
Backround Cryoglobulinemia has been reported in several chronic infectious and autoimmune diseases, and in patients with HIV‐1 infection. Cryoglobulinemia associated with hepatitis C virus infection is considered a risk factor for the development of neoplasia, especially B‐cell non‐Hodgkin lymphoma. This study was undertaken to investigate whether the presence of circulating cryoglobulins is associated with survival or development of neoplastic disease in HIV‐1 infection. Design We evaluated 87 unselected consecutive HIV‐1 infected patients for the presence of cryoglobulinemia and they were prospectively followed up for a median of 34 months, with clinic visits at 4‐month intervals. None of the patients had neoplasia at study entry. Time‐to‐event analysis for death, neoplasm and B‐cell lymphoproliferative disorder were performed with Cox proportional hazards models. Results Mixed cryoglobulinemia (types II and III) was detected in 24 (28%) of the 87 patients. During the follow up, 12 patients died and 8 developed neoplastic disease. Multivariate analysis showed that circulating cryoglobulins were an independent predictor of death [relative risk (RR), 4·97; 95% confidence intervals (CI), 1·26–19·63] and development of neoplasia (RR, 5·18; 95% CI, 1·23–21·83). In addition, cryoglobulinemia reached borderline significance as a predictor of lymphoproliferative disorder of B‐cell origin ( P = 0·08; RR, 4·53; 95% CI, 0·83–24·75). Conclusions Our results suggest that cryoglobulinemia is associated with an increased risk for death, neoplasia or development of lymphoproliferative disorder of B‐cell origin, in HIV‐1 infected patients.