CLINICAL AND VIROLOGICAL FINDINGS IN MIXED CRYOGLOBULINEMIA

Objectives. As a close relationship has been established between mixed cryoglobulinaemia and hepatitis C virus (HCV) infection, the clinical , histological and virological findings of patients affected by mixed cryoglobulinaemia were determined. Design. Hepatitis C virus infection was investigated by the presence of anti-HCV antibodies and PCR ampli fication of the 5' untranslated region (5' UTR), and the genotype of H CV was also determined according to Okamoto. A bone marrow biopsy was performed in all patients and liver and kidney biopsies when indicated . Subjects. Eighty-two subjects affected by mixed cryoglobulinaemia we re enrolled in this study. Results. The prevalence of anti-HCV antibod ies was high (83%); PCR amplification of the 5'UTR region was performe d in 52 subjects and in 44 of them (85%) the results were positive. In the same subjects, the Core region amplification was positive in 46 c ases (88%). A high prevalence of genotype II was found (54%). Chronic liver disease was present in 55 patients (67%). Bone marrow biopsies s howed the presence of low-grade non-Hodgkin's lymphomas in 11 cases (1 3%). Membrano-proliferative glomerulo-nephritis was found in seven sub jects (8%). Conclusions. Mixed cryoglobulinaemia is associated with HC V infection in the nearly all cases. Several HCV genotypes are involve d in the pathogenesis of this disease. Mixed cryoglobulinaemia is asso ciated with a high prevalence of chronic liver disease, low-grade non- Hodgkin's lymphomas and membrano-proliferative glomerulonephritis.