Mixed cryoglobulinemia is associated with increased risk for death, or neoplasia in HIV-1 infection.

Abstract

BACKGROUND:

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.

• Authors: T Kordossis, N V Sipsas, A Kontos, U Dafni, H M Moutsopoulos
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 31 Issue 12 Pg. 1078-82 (Dec 2001) ISSN: 0014-2972 [Print] England
• PMID: 11903495 (Publication Type: Journal Article)

Topics

• Adult
• Cryoglobulinemia (mortality, virology)
• Female
• HIV Infections (complications, mortality, virology)
• HIV-1
• Humans
• Lymphoma, B-Cell (mortality, virology)
• Lymphoproliferative Disorders (mortality, virology)
• Male
• Middle Aged
• Neoplasms (mortality, virology)
• Predictive Value of Tests
• Prospective Studies
• Risk Factors
• Survival Analysis