HEPATITIS-C VIRUS AND ITS GENOTYPES IN PATIENTS SUFFERING FROM CHRONIC HEPATITIS-C WITH OR WITHOUT A CRYOGLOBULINEMIA-RELATED SYNDROME

Recently, evidence has been presented for a possible association betwe en hepatitis C virus (HCV) infection and essential mixed cryoglobuline mia (EMC). Eleven consecutive patients with EMC and two with cryoglobu linemia type I were examined for the presence of markers of HCV infect ion. Eleven of 13 patients (10 with EMC and 1 with type I cryoglobulin emia) had anti-HCV antibodies (as determined by a second generation an ti-HCV assay) and HCV-RNA in plasma or serum. HCV-RNA was also detecte d in liver biopsies of five patients. Genotyping showed that HCV genot ype 1 was found in 10 of 11 patients with HCV-RNA (9 genotype 1b and 1 genotype 1a) and only one patient had HCV genotype 2. However, a simi lar high prevalence of genotype 1b (100%) was found in a group of 14 c onsecutive patients with chronic hepatitis C, who had no clinical evid ence of cryoglobulinemia. Concomitant infection was present in three p atients with genotypes 2, 3 and 4, respectively. These findings stress the high prevalence of HCV infection in patients with EMC and further study shows that a difference in genotype prevalence was not found be tween HCV-related EMC and chronic hepatitis C without clinical manifes tations of EMC. (C) 1994 Wiley-Liss, Inc.