GB Virus C Infection in Patients with Type II Mixed Cryoglobulinemia

GB Virus C Infection in Patients with Type II Mixed Cryoglobulinemia

From Ospedali Riuniti di Bergamo, Bergamo, Italy; and Consorzio per le Biotecnologie, Spedali Civili di Brescia, Brescia, Italy. Acknowledgments: The authors thank Dr. Domenico Fenili for the characterization of cryoglobulins and Paolo Misiani for assistance in the preparation of the manuscript. Requests for Reprints: Piermario Bellavita, MD, Servizio di Immunoematologia e Centro Trasfusionale, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128, Bergamo, Italy. Current Author Addresses: Drs. Misiani and Marchesi: Divisione di Nefrologia e Dialisi, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy.

Abstract

Background: Hepatitis C virus (HCV) infection is present in most but not all patients with type II mixed cryoglobulinemia.

Objective: To investigate the role of GB virus C (GBV-C) in type II mixed cryoglobulinemia.

Design: Retrospective study of serum and cryoprecipitate samples.

Setting: Tertiary care hospital in Bergamo, Italy.

Patients: 58 cryoglobulinemic patients, 35 of whom were treated with interferon-α.

Measurements: GB virus C RNA was determined by a reverse-transcription polymerase chain reaction assay done by using primers derived from the conserved GBV-C helicase region.

Results: GB virus C RNA was detected in serum specimens from 23 of 58 cryoglobulinemic patients (40% [95% CI, 27% to 53%]) and 1 of 145 healthy blood donors (0.7%) (P < 0.001). Twenty of the 23 patients with GBV-C RNA were simultaneously infected with HCV. Unlike antibodies to HCV and HCV RNA, GBV-C RNA did not concentrate in cryoprecipitate in patients co-infected with GBV-C and HCV. Furthermore, the therapeutic effectiveness of interferon-α in patients with coinfection was related to the disappearance of HCV RNA but not GBV-C RNA from serum. None of 3 patients with GBV-C infection alone had detectable GBV-C RNA in cryoprecipitate.

Conclusions: Infection with GBV-C, usually associated with HCV, is common in patients with type II mixed cryoglobulinemia but is unlikely to have a primary role in this disease.