HEPATITIS-C VIRUS-INFECTION AND LYMPHOPROLIFERATIVE DISORDERS - RESPONSE

In recent years, a high prevalence of both anti-hepatitis C virus (anti-HCV) antibodies (HCVAb) and HCV RNA has been documented in series of patients affected by cryoglobulinemia. The histologic as well as immunocytochemical analysis of the bone marrow of several patients frequently showed the presence of a clear expansioonf a B-lymphocyte population, suggesting a minimal lymphoproliferative disease or al localized immunocytoma ,according to some investigators, may evolve in an overt lymphoma. On the basis of these observations and of the reponed high prevalence of HCV infection markers in Waldenstrom’s macroglobulinemia we analyzed 201 cases of monoclonal gammopathies (MGs) for the presence of HCVAb. The cases were divided in two groups on the basis of the presence or absence of cryoglobulinemic activity. The first group included 94 patients, all affected by type 2 (monoclonal IgMK and polyclonal IgG) cryoglobulinemia, subdivided into) 62 so called “essential” cryoglobulinemias, 12 cryoglobulinemias associated w ith oven lymphoproliferative diseases and 20 cryoglobulinemias associated with autoimmune disorders. Our overall data on 201 patients confirm the strict associatlon between HCV infection and MGs with cryoglobulinemic activity, with the exception of those associated with autoimmune diseases. This relation does not seem to exist with the MGs without cryoglobulinemic activity, such as in MGs of uncertain significance, multiple myeloma, and Waldenstrom’s disease.