Transient positivity of antinuclear and anti-smooth muscle antibodies in hepatitis A virus infection

Gutiérrez, A. Escobar; Chinchilla, Virtudes Chinchilla; Espasa, Antonia; Pérez‐Mateo, Miguel

doi:10.1016/s0168-8278(96)80197-8

Cited by 12 publications

(12 citation statements)

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“…In addition, ANA positivity was frequently found in patients with AHA 12,13,22. Therefore, it was not surprising that ANA was frequently detected in patients with AHA in the present study.…”

Section: Discussionsupporting

confidence: 63%

“…Some authors suggest that ANA-positive status is associated with higher aminotransferase levels,5-7 increased severe inflammation,6 or advanced fibrosis,8 while others have found no such difference 9,10. Meanwhile, several studies suggest that ANA-positive status has no clinical impact in patients with AHA because all patients had a favorable course and ANA titer decreased or disappeared within several months 12,13. Gutiérrez et al12 suggested that the presence of ANA is the result of a non-specific immunological response to viral infection.…”

Section: Discussionmentioning

confidence: 99%

“…However, serious complications including fulminant hepatic failure or renal dysfunction could develop in some patients. Meanwhile, several studies have suggested that transient ANA detection is not rare during the course of AHA 12,13. In addition, several authors have reported cases of autoimmune hepatitis triggered by AHA 14-19.…”

Section: Introductionmentioning

confidence: 99%

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

Seo¹,

Lee²,

Jung³

et al. 2011

Gut Liver

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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.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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

Seo¹,

Lee²,

Jung³

et al. 2011

Gut Liver

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“…1,2 Infection by the hepatitis A virus (HAV) was postulated as a possible triggering factor of AH, 3 and in fact, occurrence of antiactin antibodies after HAV infection was first reported in 1983. 4 Transient antinuclear or anti-SMA, 5 as well as antiasialoglycoprotein receptor antibodies, 6 were also reported after the peak in transaminase concentrations. Additional evidence indicated that HAV is able to elicit immune reactions against viral antigens expressed on cell surfaces of infected patients.…”

mentioning

confidence: 97%

“…From the 1 Divisió n Inmunogenética, Hospital de Clínicas, and 5 Departmento de Microbiología e Immunología, Facultad de Medicina, Universidad de Buenos Aires, Argentina; 2 Divisió n Hepatología and Gastroenterología, Hospital Municipal del Niñ o, San Justo, Argentina; and 3 Divisió n Hepatología and 4 Divisió n Inmunología, Hospital Nacional de Pediatría J. P. Garrahan, Buenos Aires, Argentina.…”

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Protracted, but not acute, hepatitis A virus infection is strongly associated with HLA-DRB1*1301, a marker for pediatric autoimmune hepatitis

Velasco²,

et al. 2001

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HLA alleles are known to be associated with susceptibility to develop autoimmune hepatitis (AH), and hepatitis A virus (HAV) infection is postulated as a putative trigger for AH. We investigated whether HLA may influence the outcome of the HAV infection by studying 67 children with self-limited and 39 children with protracted forms of this infection. HLA typing of the uncomplicated forms showed no significant increase of any HLA class I or II alleles. In contrast, DRB1*1301 was present in 46.1% of the children with protracted forms (vs. 9.8% in healthy controls; relative risk [RR]: 7.6; 2 ‫؍‬ 33.3; P ‫؍‬ 2 ؋ 10 ؊9 ). In uncomplicated hepatitis, 45% developed anti-smooth muscle antibody (SMA)/actin antibodies, but only 1 child had detectable antibodies after 3 months of infection onset. In contrast, after 1 year, 69% of the patients suffering protracted forms had titers of anti-SMA/actin antibodies that ranged between 1:40 and 1:160. Within their follow-up, 2 patients developed a Hashimoto's thyroiditis, but the remaining patients showed no signs of developing autoimmune hepatitis. We conclude that the DRB1*1301 haplotype is strongly associated with the protracted forms of HAV infection and suggest that the infection allows a sustained release of liver self-antigens. However, other still-unknown susceptibility genes are required for the full development of pediatric AH. (HEPATOLOGY 2001;33:1512-1517

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Clinical significance of conventional serum autoantibodies for various liver diseases in a Chinese population

Yang

Liang

Qin

et al. 2012

Clinical Biochemistry

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Transient positivity of antinuclear and anti-smooth muscle antibodies in hepatitis A virus infection

Cited by 12 publications

References 1 publication

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

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

Protracted, but not acute, hepatitis A virus infection is strongly associated with HLA-DRB1*1301, a marker for pediatric autoimmune hepatitis

Clinical significance of conventional serum autoantibodies for various liver diseases in a Chinese population

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