HEPATITIS-C VIRUS GENOTYPES AND SUBTYPES IN PATIENTS WITH HEPATITIS-C, WITH AND WITHOUT CRYOGLOBULINEMIA

Background/Aims: Resent reports have shown a high frequency of anti-he patitis C virus antibodies in patients with cryoglobulinemia. The fact ors involved in the production of cryoglobulins in hepatitis C virus-i nfected patients are unknown. To assess the role of hepatitis C virus genotypes in the pathogenesis of mixed cryoglobulinemia, we analyzed t heir prevalence in a group of 118 hepatitis C virus-infected patients according to the presence or absence of cryoglobulins. Methods: The he patitis C virus genome was typed using the Line Probe Assay (LiPA, Inn ogenetics), for the most common genotypes (1a, 1b, 2a, 2b, 3, 4 or 5). Results: Cryoglobulinemia was diagnosed in 60 (51%) patients, 33 (55% ) of whom had type II and 27 (45%) type III cryoglobulins. Forty-four (37%) patients had no cryoglobulinemia and 14 (12%) patients had trans ient cryoglobulins. Cryoglobulins were significantly less prevalent in patients infected by genotype 1a. We found no statistical link betwee n the hepatitis C virus genotype and the presence of symptomatic cryog lobulinemia, or the hepatitis C virus genotype and the type (II or III ) of cryoglobulin. Interestingly, all six patients infected by hepatit is C virus genotype 4 or 5 had cryoglobulins. Conclusions: In patients with hepatitis C virus infection, cryoglobulinemia is not strongly as sociated with a particular HCV genotype or subtype. The mechanism by w hich cryoglobulins are produced remains to be elucidated.