Rarity of mixed cryoglobulinemia (MC) in HIV-1 (+) treatment-naïve patients (09/2006–5/07/2008) and long-term follow-up

Purpose of the study

Study of the natural course of MC in HIV-1 (+) treatment-naïve patients at presentation, who will be followed-up regularly to delineate the time course of appearance and evolution or possible disappearance of MC in association with clinical and laboratory indices, therapy and clinical outcome (development of non-Hodgkin's lymphoma [NHL]).

Methods

Currently diagnosed patients (n = 67, men = 58, women = 9, mean age = 39.17 years, Greeks = 55, foreigners = 12) at their first staging examination were tested for the presence of MC. All participating patients will be followed-up every 4 months.

Summary of results

MC was found at presentation in four, in two in the first, second and third follow-up, and in the fourth and fifth follow-up, in one. Only in one patient, who was MC (+) in the first three tests, was CD8 lymphocytosis diagnosed. In the rest of the MC (+) patients, no evidence of NHL was found so far.

Conclusion

MC has been found to occur in 27% of HIV-1 (+) patients (1996–1997) [1], but its prevalence has declined during the HAART era (12/2003–07/2004) to 7.5% [2]. It is evident in the present study that MC is rare due possibly to earlier diagnosis and the use of HAART, but the long-term follow-up will clarify the phenomenon and give medical evidence as to whether the presence of MC is an indication for the initiation of treatment.