Q J Med 1995; 88: 805-810
© 1995 Association of Physicians
Hepatitis C virus genotype in patients with essential mixed cryoglobulinaemia
Department of Nephrology, Ospedale San Carlo Borromeo Milan, Italy 1 Institute of Hygiene, University of Milan Milan, Italy 2 Service of Immunohematology, Ospedale San Carlo Borromeo Milan, Italy 3 Institute of Virology, University of Milan Milan, Italy
Address correspondence to Dr R.A. Sinico, Divisione di Nefrologia, Ospedale San Carlo Borromeo, Via Pio II, 3-20153 Milano, Italy
Received 13 April 1995 Accepted for publication 1 June 1995.
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Abstract |
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We studied 54 patients with essential mixed cryoglobulinaemia (EMC), (23 males, 31 females) mean age 61 years (range 28–77). Forty-one (76%) had type II cryoglobulinaemia and 13 (24%) type III. Antibodies to HCV were detectable by second-generation ELISA in 49 patients (91%) with confirmed or indeterminate RIBA results. HCV RNA was detected byRT PCR using 5' UTR nested primers; HCV genotypes 1a, 1b, 2 and 3a were identified by genotype-specific core-region nested primers. All patients (49) with antibodies to HCV in their serum were HCV-RNA positive; 27 (55.1%) had HCV subtype 1b and 21 (42.8%) type 2. In one patient the HCV genotype could not bedetermined. The genotype distribution was not differentfrom that found in patients with chronic hepatitis C without cryoglobulinaemia. However, the presence of HCV subtype 1b correlated significantly with signs of chronic hepatitis and presence of peripheral neuropathy. Severity of disease tended to be worse in patients infected with HCV subtype 1b, but this was mainly due to liver disease. HCV genotypes may influence the clinical expression and, in particular, the severity of liver involvement in patients with EMC. Extent and severity of EMC disease in general may also be affected by the different HCV genotypes.These findings may have therapeutical implications, since the different HCV genotypes respond differently to interferon treatment.