Florica Stăniceanu *, Sabina Zurac *, A. Streinu Cercel **
* Conf. dr: Fiorica Stăniceanu, dr. Sabina Zurac, Laboratorul de Anatomie Patologică, Spitalul Clinic Colentina, București
** Dr. Adrian Streinu-Cercel, medic primar șef de secție Institutul de Boli Infecțioase Prof. dr. Matei Balș, șef de lucrări UMF Carol Davila, București
Abstract
The improvement of the serologic tests for hepatitis C virus identification permitted the identification of the HCV infection in patients with ,.primary” immune diseases. Patients with type II and Ill mixed cryoglobulinemia (B type lymphoproliferative disease characterized by the in vitro formation of cryoprecipitate) associate HCV infection in 30-100% of the cases; the HCV virions are specifically linked Tn the circulant immune complexes and the viremia decreasing accordingly. The pathogenic mechanism is based on the chronic antigenic stimulation of B lymphocytes CDS- WA Xld+ by the HCV; the rheumatoid factor activity is gained latter in the B lymphocytes proliferation unbalanced by the T lymphocytes control.The membranoproliferative glomerulonephritis occurs in one third of the patients with HCV infection and cryoglobulinemia, as a consequence of the deposition on the glomerular level of the immune complexes that include monoclonal RF-type activity immunoglobulines and, possible, HCV virions; a interferon treatment might decrease the levels of proteinuria.The association with lichen planus was identified by epidemiological and molecular biology studies (the identification of the viral RNA with active viral replication in the oral mucosa and the identification of the infected keratinocytes); the pathogenic mechanism which are implicated are the cellular immune response against the HCV infected epithelial cells, the induction of anti GOR antibodies, the stimulation of Fas and TNF-a mediated apoptosis and the activation of Blymphotoxine.