What is the role of screening for underlying causes such as hepatitis C in patients with cryoglobulinaemia?

Screening for underlying causes, particularly hepatitis C virus (HCV) infection, is essential in patients presenting with cryoglobulinaemia. This is because HCV is the most common identifiable cause of mixed cryoglobulinaemia, and its detection directly influences management strategies and prognosis ¹. Identifying HCV infection allows targeted antiviral therapy, which can lead to remission of cryoglobulinaemia symptoms and prevent progression of liver disease (Ramos-Casals et al., 2012). Furthermore, screening helps differentiate primary (idiopathic) cryoglobulinaemia from secondary forms linked to infections, autoimmune diseases, or malignancies, guiding appropriate further investigations and treatment ¹. The UK guidelines recommend testing for hepatitis B and C in at-risk populations, which includes patients with cryoglobulinaemia, to ensure timely diagnosis and management ¹. Recent literature reinforces that comprehensive screening for HCV and other underlying causes is critical for optimal patient outcomes and may also uncover coexisting conditions that require concurrent management (Takada et al., 2012; Roccatello et al., 2018).