Moreover, there is evidence of enhanced IL-18 production (in vitro and in vivo) from studies of individuals with HCV-associated liver disease and concurrent cryoglobulinemia when compared to HCV infected controls with no cryoglobulinemia, suggesting that IL-18 and other proinflammatory cytokines may contribute to the presence of cryoglobulins during chronic HCV infection [44, 45]. Here, IL18 is linked to cryoglobulinemia.