HEPATITIS-C VIRUS-INFECTION IN TYPE-II ESSENTIAL MIXED CRYOGLOBULINEMIAS

The possible relationship between essential mixed cryoglobulinemias (E MCs) and hepatitis C virus (HCV) has been investigated in eight patien ts with type II EMCs and biochemical signs of liver damage, whose seru m tested positive in the ELISA for anti-HCV. Sera were tested using th e 2nd generation RIBA assay, while serum HCV-RNA was measured semiquan titatively by a RT-PCR in whole serum, cryoprecipitates and supernatan ts. In all patients a percutaneous liver biopsy and a bone marrow biop sy were performed. At liver biopsy, chronic active hepatitis and/or ci rrhosis were present in 6 patients; in the remaining two, a lymphoplas macytoid infiltration of elements positive for kappa light chains was found. In all patients a bone marrow biopsy showed a paratrabecular in filtration of monoclonal lymphoplasmacytoid elements similar to those found in the liver of the two patients described above. Antibodies aga inst structural and non-structural HCV proteins were detectable in the serum of all patients. HCV-RNA was amplified from the whole sera, cry oprecipitates and supernatants: significantly higher concentrations we re found in cryoprecipitates than in supernatants. Our results confirm the high prevalence of HCV infection and ongoing viral replication in patients with type II EMC and suggest the possible implication of HCV in EMC pathogenesis.