HCV AND MONOCLONAL GAMMOPATHIES

Objective. To determine the prevalence of antibodies against HCV in mo noclonal gammopathies with and without cryoglobulinemic activity. Meth ods. 201 patients were divided into two groups: (I) 94 patients with m onoclonal gammopathies with cryoglobulinemic activity, and (II) 107 wi th monoclonal gammopathies without cryoglobulinemic activity. Cryoglob ulins were characterized by immunofixation; HCVAb were detected using second-generation ELISA and RIBA methods; in 38 cases the presence of HCV in peripheral blood mononuclear cells was evaluated by PCR. Result s. The HCVAb prevalence, as evaluated by RIBA, in Group I was 69.1% wh ile in Group II it was only 14.9%. Histological and immunohistochemica l study of the bone marrow in Group I patients frequently showed signs of nodular B-cell clonal expansion. Conclusions. Our data confirm the existence of a close correlation between HCV infection and the monocl onal gammopathies with cryoglobulinemic activity. HCV-positive cryoglo bulinemia is characterized by self-limiting IgM monoclonal expansion a ssociated with histological aspects of bone marrow lymphoid nodules th at do not expand in the course of the disease like classic evolving ly mphoproliferative processes.