HCV GENOTYPES IN BONE-MARROW AND PERIPHERAL-BLOOD MONONUCLEAR-CELLS OF PATIENTS WITH MIXED CRYOGLOBULINEMIA

Objective. The association of the hepatitis C virus (HCV) with the cry oglobulinemic syndrome is well known, but its pathogenetic mechanism s till remains to be clarified HCV-RNA has been found in the peripheral blood mononuclear cells (PBMC) of infected subjects. We investigated t he presence of the HCV genome in bone marrow cells (BMC), and the dist ribution of different HCV genotypes in individuals with mixed cryoglob ulinemia (MC) and in non-cryoglobulinemic controls, Methods. 15 anti-H CV positive subjects with MC, 7 non-cryoglobulinemic patients with typ e C chronic active hepatitis (CAH) and 2 anti-HCV negative controls we re studied. HCV-RNA was detected by nested PCR of the highly conserved 5'-NCR sequence. HCV typing was carried out by means of the hybridiza tion of the same amplified region with specific probes. Results. HCV-R NA was present in the PBMC of a large proportion of the MC patients an d controls without any significant differences. On the contrary, HCV-R NA was present in the bone marrow cells of all the patients with MC an d in 43% of the CAH controls. The HCV 1b and 2a genotypes seem to be t he most prevalent among MC patients. Nevertheless, the patients with t ype II MC had a very high prevalence of the 2a genotype (77%). Conclus ion. The results suggest that the presence of HCV-RNA in bone marrow c ells may be correlated to the pathogenetic mechanism of MC. Other stud ies are needed to confirm the frequent association of HCV genotype 2 w ith MC.