Serum autoantibodies in chronic hepatitis C: Comparison with autoimmune hepatitis and impact on the disease profile

Abstract

ANA-H and/or SMA-AA does not exclude AIH, the characterAntibodies to nuclei (ANA), smooth muscle (SMA), and ization of ANA and SMA may help to discriminate between liver/kidney microsomes type 1 (anti-LKM1) may occur in the two conditions. As compared with the seronegative counchronic hepatitis C. Distinct subspecificities, including ANA terpart, autoantibody-positive chronic hepatitis C is more with the homogeneous pattern (ANA-H) and SMA with anticommon in females and exhibits a more severe biochemical actin specificity (SMA-AA), are found in autoimmune hepatiand histological activity. The response to IFN therapy, howtis (AIH). This study was performed to characterize the hepaever, is similar. (HEPATOLOGY 1997;26:561-566.) titis C virus (HCV)-associated autoantibodies and to evaluate their influence on the profile of the disease. Two hundred ninety consecutive patients with chronic hepatitis C and 35A variety of immunological abnormalities has been decontrol cases with AIH were screened for autoantibodies by scribed in patients with chronic hepatitis C. In particular, indirect immunofluorescence (IFL) at 1:40 serum dilution. the occurrence of serum non-organ-specific autoantibodies The ANA pattern was defined by IFL on HEp-2 cells and the has been extensively studied: smooth muscle (SMA) and anti-SMA-AA identified by the presence of at least two of the nuclear (ANA) antibodies have been detected in approxifollowing elements: 1) SMA T or SMA G pattern by IFL on mately one third of the cases, 1,2 while antibodies to liver/ kidney sections; 2) XR 1 precipitating system by counterimmu-kidney microsomes type 1 (anti-LKM1) have been found noelectrophoresis; or 3) typical pattern by IFL on liver sec-more rarely (from 0% to 5%). [2][3][4] Variations in the autoantitions from phalloidin-intoxicated rats. ANA, SMA, and anti-body prevalence among the reports so far published 1-7 have LKM1 occurred in 9%, 20%, and 6% of chronic hepatitis C been attributed both to different experimental conditions in cases, respectively. The overall prevalence of autoantibodies the immunofluorescence (IFL) procedure and to ethnical and was 30% (87 of 290). Compared with AIH, HCV-associated geographical differences in the study populations. ANA and SMA exhibited ANA-H and SMA-AA at a lower Most reports agree that the autoantibody positivity does prevalence (38% vs. 71%, P Å .04 and 8% vs. 87%, P õ not influence either the clinical and biochemical profile of .000001, respectively) and had a lower median titer (1:80 vs. chronic hepatitis C or the response to interferon (IFN) alfa. 1:320, P õ .001 and 1:40 vs. 1:320, P õ .000001, respec-Some data, however, have been published on the occurrence tively). The concomitant positivity for ANA-H and SMA-AA of disease activity exacerbations in patients with serum autowas detected in none of the HCV cases, but in 46% of AIH antibodies during IFN treatment. 8-10 sera (P õ .000001). Two parameters were independently asThe major impact of the above autoantibodies in the hepasociated with the autoantibodie...

Prevalence of Autoantibodies in Patients with Hepatitis C Virus Infection in Oman

“…Consistent with results from previous studies, 10,28,31,32,33 we found that the prevalence of autoantibodies in HCV patients was significantly higher than those in uninfected controls. Our study showed a high prevalence of ASMA, ANA and RF.…”

“…9 Other investigators have reported that the prevalence of ANA, ASMA and AL/KM was higher than in normal subjects. 10,31 In one study, the prevalence of ASMA was found to be 30%, 31 the same percentage found in our study. It is of interest that our results are in accord with the prevalence found in another study carried out in the Middle East.…”

“…Unlike steroid therapy, interferon-alpha is reported to aggravate autoimmunity in HCV patients. 46 An important observation that can be drawn from this study and others 10,31,32 is the irregular pattern and inconsistent findings among patients, suggesting that the development of autoantibodies was caused by tissue destruction which in turn, correlates to the severity of the autoimmune disease associated with HCV infection. This might be confirmed by performing follow-up studies to monitor the type and titer of associated population and virus genotype between Oman and the countries where the previous studies were carried out.…”

Development of Hepatocellular Carcinoma in a Woman with HBV- and HCV-negative Autoimmune Hepatitis with Unsatisfactory Response to Corticosteroid

“…A variety of immunological abnormalities have been described in patients with chronic hepatitis C, and in particular, a high prevalence of positivity for autoantibodies was reported (14,15). Furthermore, patients with autoantibodies had more severe portal-periportal necroinflammation (15).…”

“…Furthermore, patients with autoantibodies had more severe portal-periportal necroinflammation (15). Many patients diagnosed with autoimmune hepatitis before the availability of hepatitis C virus testing were thought to have hepatitis C virus infection (2).…”