Hepatitis C virus infection in type II essential mixed cryoglobulinemias
The possible relationship between essential mixed cryoglobulinemias (EMCs) and hepatitis C virus (HCV) has been investigated in eight patients with type II EMCs and biochemical signs of liver damage, whose serum tested positive in the ELISA for anti-HCV. Sera were tested using the 2nd generation RIBA assay, while serum HCV-RNA was measured semiquantitatively by a RT-PCR in whole serum, cryoprecipitates and supernatants. In all patients a percutaneous liver biopsy and a bone marrow biopsy were performed. At liver biopsy, chronic active hepatitis and/or cirrhosis were present in 6 patients; in the remaining two, a lymphoplasmacytoid infiltration of elements positive for kappa light chains was found. In all patients a bone marrow biopsy showed a paratrabecular infiltration of monoclonal lymphoplasmacytoid elements similar to those found in the liver of the two patients described above. Antibodies against structural and non-structural HCV proteins were detectable in the serum of all patients. HCV-RNA was amplified from the whole sera, cryoprecipitates and supernatants: significantly higher concentrations were 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.
KeywordsBone Marrow Biopsy Chronic Active Hepatitis Mixed Cryoglobulinemia Kappa Light Chain Percutaneous Liver Biopsy
Unable to display preview. Download preview PDF.
- 1.Abate ML, Saracco G, Negro F, Brunetto MR, Bonino F (1992) Quantitative detection of hepatitis C viraemia by HCV-RNA RT-PCR: clinical applications. Ital J Gastroenterol 24: 251Google Scholar
- 2.Artini M, Natoli G, Avantaggiati ML, Balsano C, Chirillo P, Bonavita MS, Levrero M (1992) HCV replicates in the peripheral blood mononuclear cells from chronic HCV carriers. Proceedings of the first annual meeting on hepatitis C virus and related viruses, Venice 1992, p 32Google Scholar
- 5.Chomzczynski A, Sacchi F (1987) Single step method of RNA isolation by acid guanidinium, thiocyanate-phenol-chloroform extraction. Anal Biochem 162: 156–159Google Scholar
- 6.Chung RT, Agnello V, Weiner NJ, Dienstag JL, Kaplan LM (1992) A role for hepatitis C virus infection in the pathogenesis of essential mixed cryoglobulinemia: selective concentration of HCV antigen and RNA in cryoprecipitates. Gastroenterology 104: 1092Google Scholar
- 7.deBandt M (1992) Role du virus de l’hépatite C dans les cryoglobulinémies mixtes “essentielles” et le syndrome de Gourgerot-Sjogren. Presse Med 21: 1750–1752Google Scholar
- 17.Houlf S, Romain P, Szymanski L, Bonkovski H (1992) Hepatitis C: An important cause of mixed cryoglobulinemia. Gastroenterology 102: 105Google Scholar
- 19.Lunel F, Musset L, Cacoub P, Perrin M, Frangeul JC, Piette O, Bousquet P, Godeau D, Valla Y, Le Charpentier P, Opolon P, Haraux JM (1992) Prevalence of mixed cryoglobulinemia in 112 patients with viral and non viral chronic hepatitis or cirrhosis. Proceedings of the first annual meeting on hepatitis C virus and related viruses, Venice 1992, p 179Google Scholar
- 23.Muller HM, Kallinovski B, Solbach C, Goeser T, Theilmann L, Pfaff E (1992) Peripheral blood mononuclear leukocytes as a potential site for extrahepatic replication of hepatitis C virus: predominant role of B-lymphocytes in viral propagation. Proceedings of the first annual meeting on hepatitis C virus and related viruses, Venice 1992, p 31Google Scholar
- 24.Pascual M, Perrin L, Giostra E, Schifferli JA (1990) Hepatitis C virus in patients with cryoglobulinemia type II. J Infect Dis 335: 559–560Google Scholar
- 26.Zignego AL, Macchia D, Monti M, Thiers V, Romagnani S, Gontallini P, Brechot C (1992) Hepatitis C virus infection of fresh and cultured peripheral blood mononuclear cells. Ital J Gastroenterol 24: 310Google Scholar