title: The association of hepatitis C virus infection with monoclonal rheumatoid factors bearing the WA cross-idiotype: implications for the etiopathogenesis and therapy of mixed cryoglobulinemia.
abstract: OBJECTIVE
  To determine the prevalence of monoclonal rheumatoid factors (mRF) bearing the WA cross-idiotype (WA XId) in hepatitis C virus (HCV) positive type II mixed cryoglobulins, to review recent studies on the role of HCV in the cutaneous vasculitis lesions in patients with type II cryoglobulinemia and to discuss the implication of these studies for the etiopathogenesis and therapy of the disease.
  
  
  METHODS
  Thirty type II cryoglobulins were tested for WA and PO XId and for HCV RNA:
  
  
  RESULTS
  WA mRF were strongly, although not exclusively, associated with HCV in type II mixed cryoglobulinemia.
  
  
  CONCLUSIONS
  These and other recent studies from our laboratory suggest that chronic HCV infection may be the stimulus for the production of WA mRF and that HCV may be directly involved in the pathogenesis of the cutaneous vasculitis in patients with type II cryoglobulinemia. The association of HCV infection with the disease provides a rationale for anti-viral therapy and for monitoring therapy by measuring the HCV level in both blood and liver.
authors.affiliation: Lahey Hitchcock Medical Center, Burlington MA 01805, USA.
authors.forename: V
authors.initials: V
authors.lastname: Agnello
authors.forename: Q X
authors.initials: QX
authors.lastname: Zhang
authors.forename: G
authors.initials: G
authors.lastname: Abel
authors.forename: G B
authors.initials: GB
authors.lastname: Knight
mesh_terms: D001324:Autoantigens / Q000032:analysis*; D003429:Cross Reactions; D003449:Cryoglobulinemia / Q000276:immunology / Q000628:therapy / Q000821:virology*; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D006801:Humans; D007130:Immunoglobulin Idiotypes / Q000032:analysis*; D008297:Male; D012217:Rheumatoid Factor / Q000032:analysis*
chemical_list: D001324:Autoantigens; D007130:Immunoglobulin Idiotypes; C069985:Wa antigen; D012217:Rheumatoid Factor