title: Hepatitis C virus-related mixed cryoglobulinemia: is genetics to blame?
abstract: Mixed cryoglobulinemia (MC) is the extrahepatic manifestation most strictly correlated with hepatitis C virus (HCV) infection; it is a benign autoimmune and lymphoproliferative disorder that evolves to lymphoma in 5%-10% of cases. MC is reputed to be a multistep and multifactorial process whose pathogenicity is still poorly understood. It is still unknown why only some chronically infected HCV patients develop MC and only some of these exhibit systemic symptoms (MC syndrome). Several studies have investigated the pathogenetic basis of MC and the most recent ones suggest that the virus is able to trigger such a disorder only in the presence of genetic factors that are still unknown. Here, we try to clarify the complex relationship between HCV-related MC and the host's genetic background. The data that we report are heterogeneous and sometimes even conflicting. Therefore, large, multicenter studies are clearly needed. The identification of a characteristic genetic signature of cryoglobulinemic patients would be an important step toward a personalized approach in their clinical care. The new wide-ranging genomics technologies will hopefully help to resolve these complex issues.
authors.affiliation: Laura Gragnani, Elisa Fognani, Alessia Piluso, Anna Linda Zignego, Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Gragnani
authors.affiliation: Laura Gragnani, Elisa Fognani, Alessia Piluso, Anna Linda Zignego, Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Fognani
authors.affiliation: Laura Gragnani, Elisa Fognani, Alessia Piluso, Anna Linda Zignego, Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Piluso
authors.affiliation: Laura Gragnani, Elisa Fognani, Alessia Piluso, Anna Linda Zignego, Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
authors.forename: Anna Linda
authors.initials: AL
authors.lastname: Zignego
mesh_terms: D003449:Cryoglobulinemia / Q000235:genetics* / Q000628:therapy / Q000821:virology*; D020022:Genetic Predisposition to Disease; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D010641:Phenotype; D057285:Precision Medicine; D011379:Prognosis; D012307:Risk Factors
keywords: Genetics; Hepatitis C virus; Host pathogenetic factors; Mixed cryoglobulinemia; Viral pathogenetic factors