HEPATITIS-C VIRUS-INFECTION AND MONOCLONAL GAMMOPATHIES NOT ASSOCIATED WITH CRYOGLOBULINEMIA

A pathogenetic role of HCV has been recently postulated in some lympho proliferative disorders and in particular in essential mixed cryoglobu linemia. To assess the relevance of HCV infection in multiple myeloma, Waldenstrom's macroglobulinemia and monoclonal gammopathy of undeterm ined significance in the absence of cryoglobulinemia (cryo-ve MG), 102 patients were evaluated for antiHCV, HCVRNA and HCV genotypes. A cont rol group of 466 patients referring for acute trauma to the Orthopedic Division of our hospital was also studied. The overall prevalence of HCV was 15.6% in MG patients and 5.4% in the control group (P = <0.001 ). Since only patients with MG older than 50 years had HCV infection, we compared the prevalence rate of infection in patients aged 50 and o lder: in cryo-ve MG HCV prevalence was 17.9%, while in patients with a n acute trauma it was 10%; the difference was not statistically signif icant. In addition, occurrence of cryo-ve MG was investigated in 614 a ntiHCV+ patients with chronic liver disease and was found in 1.9%. Com paring all the 28 cryo-ve MG patients HCV+ with an appropriately match ed control group of HCV+ patients without MG, no difference in severit y of liver disease and genotype distribution was detected. These findi ngs show that: (1) among cryo-ve MG, HCV infection is frequent as show n in the appropriately matched control population; (2) prevalence of c ryo-ve MG in antiHCV patients with chronic liver disease is similar to the rate found in the general population; and (3) HCV infection and d isease do not differ in patients with and without cryo-ve MG.