Disappearance of cryoglobulins and remission of symptoms in a patient with HCV-associated type II mixed cryoglobulinemia after HIV-1 infection

Objective. We report the case of a woman with long-lasting mixed cryoglobulinemic syndrome, who experienced clinical and laboratory remission of her cryoglobulinemia after becoming infected with human immunodeficiency virus and developing HIV-1 induced immunosuppression. Methods. Serum cryoglobulin concentrations and the CD4+ cell count were monitored every three months. Results. After the diagnosis of HIV-1 infection, the immunological status of the patient was constantly depressed (CD4+ cell count dropping from 337/mu L in January 1991 to 21/mu L in June 1994). Serum cryoglobulins were persistently absent over 43 months of follow-up, despite the presence of HCV-RNA,. Conclusion. In this case, HIV-1 induced immunodeficiency seems to be responsible for the remission of the cryoglobulin syndrome and the disappearance of serum cryoglobulins. These findings indicate that CD4+ T lymphocytes may play a role in regulating the activity of cryoprecipitating rheumatoid factor secreting B cell clones.