PREVALENCE OF MONOCLONAL GAMMOPATHIES IN PATIENTS WITH HEPATITIS-C VIRUS-INFECTION

Background: An association between monoclonal gammopathies and chronic liver diseases has been reported. Objective: To determine the prevale nce of monoclonal gammopathies in patients with chronic hepatitis C vi rus (HCV) infection and the possible association of monoclonal gammopa thies with HCV genotypes. Design: Prospective study. Setting: Departme nts of internal medicine and hematology at two university hospitals in Italy. Patients: 239 HCV-positive and 98 HCV-negative patients with c hronic liver diseases were recruited consecutively. Measurements: Clin ical data were gathered, liver histologic examination was done, serum immunoglobulin and cryoglobulin levels were measured, and immunoelectr ophoresis was done for monoclonal component detection. Patients with m onoclonal gammopathy had serum HCV RNA measured and HCV genotype deter mined by polymerase chain reaction and had histologic examination of b one marrow. Results: Monoclonal band was detected in 11% of HCV-positi ve patients and in 1% of HCV-negative patients (P = 0.004). The preval ence of HCV genotype 2a/c was higher in patients with monoclonal gammo pathies than in those without (50% compared with 18%; P = 0.009). Conc lusion: The prevalence of monoclonal gammopathies in patients with HCV -related chronic liver disease is striking and is often associated wit h genotype 2a/c infection.