Cryoglobulinemia in HCVAb+ patients on chronic hemodialysis

Striking evidence of HCV infection has been found in mixed cryoglobulinemia (MC) and HCV has been hypothesized to be the causative agent of this disease. To assess the association of C virus infection and cryoglobulinemia we studied cryoglobulin levels in 66 patients on maintenance hemodyalisis who were selected on the basis of HCVAb positivity and not because they were affected by liver disease. The control group was made up of 45 patients also on hemodyalisis but without HCV infection.

Circulating cryoglobulins were found in 34 (52%) of 66 HCV+ patients: the cryocrit was < 1% in 20, 1 to 5% in 12, and > 5% in 2 patients. The cryoglobulins were classified by immunofixation as type II in 8 and type III in 8 others; identification was not possible in 18 cases. In the HCVAb- control group untypable cryoglobulins were detected in 9% of the patients at < 1% by volume. No correlation was found between these data and the liver disease detected by biohumoral tests.

Our data confirm the close link between HCV infection and cryoglobulins; the prevalence of circulating cryoglobulins in uremic HCVAb+ patients is very close to that found in HCV-related liver disease.