Antineutrophil Cytoplasmic Antibody Frequency in Chronic Hepatitis B Patients

Abstract

Background. Chronic hepatitis B (CHB) is a viral disease, common across the world, and associated with several extraintestinal manifestations including vasculitis. Antineutrophil cytoplasmic antibodies (ANCAs) are sensitive and specific markers for vasculitides. There is limited data available in the literature on whether ANCA formation is stimulated by CHB infection. In the present study we aimed to identify the frequency of ANCA in CHB patients. Methods. A total of 174 subjects were included in the study (87 CHB patients, 87 control subjects). Perinuclear-ANCA (P-ANCA), cytoplasmic-ANCA (C-ANCA), myeloperoxidase ANCA (MPO-ANCA), and proteinase 3-ANCA (PR3-ANCA) were studied. IFA was used for P-ANCA and C-ANCA assays, and ELISA was used for MPO-ANCA and PR3-ANCA assays. Results. ANCA positivity was high in both groups (31% in the CHB group and 26% among controls). There were no significant differences between the groups for P-ANCA and MPO-ANCA (P = 0.6 and P = 0.6, resp.). Frequency of borderline positive C-ANCA and all positive PR3-ANCA (positive + borderline positive) was significantly higher in the CHB group (P = 0.009 and P = 0.005, resp.). Conclusions. In the present study, the frequency of ANCA was high in both groups. The CHB group had a relatively higher frequency of ANCA positivity compared to controls. Borderline positive C-ANCA and positive PR3-ANCA were significantly higher in the CHB group. These results suggest that ANCA may have a high prevalence in Turkey. Patients with CHB should be evaluated particularly for C-ANCA and PR3-ANCA in the presence of vasculitic complaints and lesions.

A Rare Case of Pulmonary-Renal Syndrome With Triple-Seropositive for Myeloperoxidase-Anti-Neutrophil Cytoplasm Antibody (MPO-ANCA), Proteinase 3 (PR3)-ANCA and Anti-Glomerular Basement Membrane (GBM) Antibodies

“…Ghonaim et al developed a study of chronic viral hepatitis patients and showed higher frequency of ANCA in chronic HCV infection than in the group control, but the same was not observed in chronic HBV group. However, in a study performed by Calhan et al, the frequency of ANCA was higher in chronic HBV patients in comparison with healthy controls [11]. HBV is associated with several extrahepatic manifestations such as vasculitis [11,12] due to deposition of immune complexes [12].…”

“…However, in a study performed by Calhan et al, the frequency of ANCA was higher in chronic HBV patients in comparison with healthy controls [11]. HBV is associated with several extrahepatic manifestations such as vasculitis [11,12] due to deposition of immune complexes [12]. The causal relationship between chronic HBV infection and polyarteritis nodosa was the only well established in the literature.…”

Hepatitis B Virus-associated Vasculitis: Multiple Cavitary Masses in the Lung Mimicking Granulomatous Polyangiitis

“…Although the presence of serum ANCA has proven useful for the diagnosis of ANCA-associated vasculitis in appropriate clinical setting, it is often elevated in a non-specific manner (13). In previous studies for hepatitis virus infection, the frequency of ANCA was not low in patients with HBV and hepatitis C virus (HCV) infection, and some patients with hepatitis virus infection demonstrated ANCA-associated vasculitis (3,14,15). The pathogenesis of hepatitis virus triggering autoantibodies or autoimmune disease, such as ANCA or ANCA-associated vasculitis, remains unknown.…”

Hepatitis B virus induced cytoplasmic antineutrophil cytoplasmic antibody-mediated vasculitis causing subarachnoid hemorrhage, acute transverse myelitis, and nephropathy: a case report

“…A significant number of patients with transverse myelitis have been found to be p-ANCA and c-ANCA positive, albeit these cases were idiopathic [10]. Moreover, borderline positive c-ANCA was significantly higher in chronic hepatitis B group as compared to control [2]. …”

“…It is associated with several extrahepatic manifestations including but not limited to serum sickness, polyarteritis nodosa, urticaria, leukocytoclastic vasculitis, and essential mixed cryoglobulinemia. In addition to these manifestations, hepatitis B virus (HBV) has also been documented to be involved in the etiopathogenesis of antineutrophil cytoplasmic antibodies (ANCA)-positive vasculitis [2]. …”