THE ASSOCIATION OF HEPATITIS-C VIRUS-INFECTION WITH MONOCLONAL RHEUMATOID FACTORS BEARING THE WA CROSS-IDIOTYPE - IMPLICATIONS FOR THE ETIOPATHOGENESIS AND THERAPY OF MIXED CRYOGLOBULINEMIA

Objective. To determine the prevalence of monoclonal rheumatoid factor s (mRF) bearing the WA cross-idiotype (WA Xld) in hepatitis C virus (H CV)positive type II mixed cryoglobulins, to review recent studies opt the role of HCV in the cutaneous vasculitis lesions in patients with t ype II cryoglobulinemia and to discuss the implication of these studie s for the etiopathogenesis and therapy of the disease. Methods. Thirty type II cryoglobulins were tested for WA and PO Xld and for HCV RNA. Results. WA mRF were strongly, although not exclusively, associated wi th HCV in type II mixed cryoglobulinemia. Conclusion. These and other recent studies from our laboratory suggest that chronic HCV infection may be the stimulus for the production of WA mRF and that HCV may be d irectly involved in the pathogenesis of the cutaneous vasculitis in pa tients with type II cryoglobulinemia. The association of HCV infection with the disease provides a rationale for anti-viral therapy and for monitoring therapy by measuring the HCV level in both blood and liver.