EVIDENCE OF HEPATITIS-C VIRUS-ANTIBODIES IN THE CRYOPRECIPITATE OF PATIENTS WITH MIXED CRYOGLOBULINEMIA

Objective. To describe the clinical features of a patients with mixed cryoglobulinemia and hepatitis C virus (HCV) infection. Methods. A cli nical study of the patients was performed. Anti-HCV antibodies were de termined by ELISA and confirmed by immunoblot (RIBA) in the sera and i n the cryoprecipitate. Results. All patients had liver dysfunction, wh ile most had arthralgias and/or arthritis, purpura, peripheral nervous system involvement and renal disorders. Cryocrits ranged from 1 to 6% . Six patients had type III mixed cryoglobulinemia and the remaining 2 had type II, History of blood transfusion was recorded in 2 patients. Hepatitis B virus (HBV) markers were negative in all sera samples. Th e cryoprecipitate of 7 patients was negative for HBV markers, but anti -HCV antibodies were positive by both ELISA and RIBA. Conclusion. Afte r reviewing published reports and discussing the possible role that he patitis C virus plays in the pathogenesis of mixed cryoglobulinemia, w e conclude that HCV may stimulate immune complex formation and produce cryoglobulinemia. Therefore its investigation is recommended before t he diagnosis of ''essential'' mixed cryoglobulinemia is established.