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

  1. T. Kordossis,
  2. N. V. Sipsas,
  3. A. Kontos,
  4. U. Dafni,
  5. H. M. Moutsopoulos

Article first published online: 21 DEC 2001

DOI: 10.1046/j.1365-2362.2001.00934.x

Issue

European Journal of Clinical Investigation

European Journal of Clinical Investigation

Volume 31, Issue 12, pages 1078–1082, December 2001

Additional Information

How to Cite

Kordossis, T., Sipsas, N. V., Kontos, A., Dafni, U. and Moutsopoulos, H. M. (2001), Mixed cryoglobulinemia is associated with increased risk for death, or neoplasia in HIV-1 infection. European Journal of Clinical Investigation, 31: 1078–1082. doi: 10.1046/j.1365-2362.2001.00934.x

Author Information

  1. National and Kapodistrian University of Athens, Athens, Greece

*Pathophysiology Department, Laikon General Hospital and School of Medicine (T. Kordossis, N. V. Sipsas, A. Kontos, H. M. Moutsopoulos) and Department of Public Health, Faculty of Nursing (U. Dafni), School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.Correspondence to: Theodore Kordossis, MD, Pathophysiology Department, Athens University Medical School, Mikras Asias 75, 115 27 Athens, Greece. Tel.: + 30–1−778–9480; fax: + 30–1−770–3876; e-mail:tkordoss@med.uoa.gr

Publication History

  1. Issue published online: 21 DEC 2001
  2. Article first published online: 21 DEC 2001
  3. Received 14 May 2001; accepted 12 September 2001

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Keywords:

  • Cancer;
  • cryoglobulinemia;
  • HIV-1 infection;
  • lymphoma;
  • risk factor;
  • survival

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.

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