Clinical Significance of the Detection of Antinuclear Antibodies in Patients with Acute Hepatitis A

Abstract

Background/AimsThe findings of several recent studies suggest that antinuclear antibodies (ANAs) are frequently detected in patients with acute hepatitis A (AHA). However, the clinical significance of a positive ANA test remains uncertain. This study was performed to evaluate the clinical significance of ANAs in AHA patients.MethodsAll patients admitted with AHA were consecutively enrolled in this study. An ANA assay was performed by indirect immunofluorescence during hospitalization. ANA positivity was defined as an ANA titer ≥1:80. The peak international normalized ratio (INR), peak alanine aminotransferase (ALT) and peak bilirubin levels were assessed over the duration of the hospitalization, and the incidence of AHA complications was evaluated.ResultsA total of 422 patients were enrolled in this study (age, 31±7 years), of which 260 (61.6%) were men. ANAs were detected in 179 AHA patients (42.4%). The proportion of ANA-positive patients varied significantly with AHA status on the day of the ANA assay (4.7% during the prodromal period vs 52.1% during the icteric or recovery period, p<0.001) and sex (56.2% in women vs 33.8% in men, p<0.001). The ANAs became undetectable in all ANA-positive patients within 3 months. The incidence of complications, including mortality, fulminant hepatic failure, renal dysfunction, relapse, and cholestatic hepatitis, did not differ significantly between ANA-positive and ANA-negative patients.ConclusionsANAs were detected frequently and transiently in patients with AHA, especially after their peak-ALT day. The presence of ANAs may not be associated with the clinical outcome of AHA, but simply with AHA status on the ANA assay day.

Pseudothrombocytopenia or platelet clumping as a possible cause of low platelet count in patients with viral infection: a case series from single institution focusing on hepatitis A virus infection

“…This highlights the importance of the accurate measurement of platelet count in the early assessment of acute hepatitis A patients, and in a same context, our study could represent high clinical value. Higher incidences of autoantibody were also reported in a few studies on acute hepatitis A patients . However, further studies are needed to uncover the causal relationship between autoantibody and PTCP.…”

Prevalence of Autoantibodies Reveals a Predominant Sma and Anca-Pr3/Mpo Pattern in Hiv Infection and Sma in Hav-Infected Children

“…HAV infection has been associated with development of extrahepatic manifestations and autoimmune diseases that are related with the production of autoantibodies in susceptible individuals (Dan and Yaniv, 1990;Huppertz et al, 1995;Skoog et al, 2002;Moon et al, 2009;Ilan et al, 1990;Tabor, 1987;Segev et al, 2001;Cohen et al, 1993;Muñoz Bertrán et al, 2002;Fainboim et al, 2001;Elfaramawy et al, 2010;Singh et al, 2007). Transient increased levels of autoantibodies have been documented in acute HAV infection and after vaccination (Fainboim et al, 2001;Karali et al, 2011;Gutierrez et al, 1996;Vento et al, 1988;Holborow et al, 1971;Seok et al, 2011). However, persistent autoantibodies have been detected in prolonged HAV infection in children (Fainboim et al, 2001;Elfaramawy et al, 2010).…”

“…Particularly, SMA, ANA and antiasialoglycoprotein receptor antibodies have been associated with HAV infection (Moon et al, 2009;Fainboim et al, 2001;Elfaramawy et al, 2010;Karali et al, 2011;Gutierrez et al, 1996;Vento et al, 1988;Holborow et al, 1971;Seok et al, 2011).…”

Antinuclear antibodies and interleukin responses in patients with Schistosoma japonicum infection

“…Absorbance was measured at 450 nm using a microtitre plate reader (Thermo Scientific, Bartlesville, OK, USA). The presence of ANA in serum was determined by the indirect fluorescent antibody test (IFAT) performed with the human liver cancer cell line Hep‐G2 as antigen substrate (Ormond Medical Experimental Diagnostic Co., Ltd., Hangzhou, China). The procedure was performed according to the manufacturer's instruction and the results reported according to the International Consensus on ANA Patterns (ICAP) by an experienced clinical laboratory technician in a blinded manner …”