Autoantibodies in chronic hepatitis C virus infection and their association with disease profile

Abstract

Autoantibodies are commonly detected in chronic hepatitis C (HCV) but their significance remains uncertain. We assessed the prevalence of anti-nuclear (ANA) and anti-smooth muscle (ASM) antibodies within a cohort of 963 treatment-naïve HCV patients. We also assessed for differences between autoantibody-positive and autoantibody-negative patients in demographics, markers of disease activity and response to anti-viral treatment. One hundred and seventy-two patients (17.9%) had at least one autoantibody, of which were 104 (10.8%) ASM, 54 (5.6%) ANA and 14 (1.5%) positive for both. Autoantibody-positive patients were older (43 vs 39 years, P = 0.001) caused by an age-related increase in ANA (but not ASM). There were no differences in gender, alcohol intake, ethnicity or viral genotype. The presence of autoantibodies, and specifically ASM, was associated with an increase in interface hepatitis score amongst men (1.1 vs 0.8, P = 0.005) but no difference in other necroinflammatory measures, liver function tests or immunoglobulins (Ig). There was no difference in initial fibrosis stage or rate of fibrosis progression. Autoantibodies did not affect response to anti-viral treatment. We conclude that autoantibodies are frequent in HCV infection. Anti-nuclear antibodies increase with age, whereas ASM antibodies are associated with interface hepatitis in men. Neither autoantibody carries increased risk of fibrosis progression or failure of therapy.

Antinuclear antibody titer and treatment response to peginterferon plus ribavirin for chronic hepatitis C patients

“…ANAs are associated with increasing age in both sexes [36]. The incidence of ANAs increases with age and the host factors of aging have also shown a strong association with fibrosis progression in HCV infection [37].…”

The Prevalence of Autoantibodies in Patients with Chronic Hepatitis C and the Relationship between Autoantibodies and HCV RNA Positivity

“…Kronik HCV infeksiyonlu hastaların yaklaşık % 25-30'unda organ spesifik olmayan otoantikor varlığı bildirilmiş-tir (3) . Kronik HCV infeksiyonlu hastalarda özel-likle organ spesifik otoantikorlar tespit edilmesine rağmen, bu otoantikorların patogenez, karaciğer hasarının derecesi ve klinik açıdan önemi tam olarak anlaşılamamıştır (5,6,7,14) . Bazı çalışma-larda, HCV infeksiyonunda otoantikor pozitifliğinin yaş, nekroinflamasyon derecesi, siroz, transaminazlarda artış ve antiviral tedaviye zayıf yanıt ile ilişkili olduğu bildirilirken, bazı çalışmalarda otoantikor pozitifliği ile bu faktör-ler arasında herhangi bir ilişki tespit edilmemiş-tir (14) .…”

“…Williams ve ark. (14) kronik hepatit C hastalarında ANA pozitifliğini % 10.8, ASMA pozitifliğini % 5.6 olarak bildirmişlerdir. NarcisoSchiavon ve ark.…”

Severe Neutropenia in Patients with Chronic Hepatitis C: A Benign Condition

“…In a recent study of 224 patients, 9.4% were ANA positive, with higher aminotransferase values than the ANA-negative patients, but no difference in response to IFN therapy. Hematologic parameters of those patients were not reported [11]. …”