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The Spectrum of Auto-Antibodies on Chronic Hepatitis C Virus (HCV) Infection: The Importance of Autoimmune Association. |
| 1Hamdy H. Soliman , 2Wafaa A. El-Mosallamy, 3Eman M.F. Farag and 2Somaya M. Desouky. |
| 1Department of General Medicine, Zagazig Faculty of Medicine, 3Department of Hepatology, Gastroentrology And Infectious Diseases and 2Department of Microbiology and Immunology Benha Faculty of Medicine, Zagazig University, Egypt. |
To evaluate the pattern, prevalence and CLINICAL importance of an array of autoantibodies in chronic HCV infection, 117 cases were studied [70 with chronic HCV, 27 with chronic hepatitis B virus (HBV) infection, and 20 normal control. Clinical evaluation, testing for schistosomiasis, liver functions, and testing for anti-HCV antibody (Ab) by second generation ELISA and for HBsAg were performed. The antinuclear (ANA), antismooth muscle (ASMA), anti-mitochondrial (AMA), anti-liver-kidney microsome type1 (LKM1 Ab), antithyroglobulin (ATG) and antithyroid microsomal (ATM) antibodies were screened by indirect immunofluorescence. Autoantibodies were positive if the titer is > 1/20. One or more autoantibodies was found in 78.6% of HCV cases (versus 18.5% in chronic HBV and 5% in normals. The prevalences of autoantibodies in the HCV group were : 68.6% for ANA, 55.7% for ASMA, 52.6% for anti-LKM1, 2.9% for each of AMA and ATG and 1.4% for ATM. These prevalences of plasma ANA, ASMA and anti-LKM1 Ab were significantly higher than those in the other 2 groups (P < 0.001). Unlike autoimmune liver disease, the prevalence of autoimmune markers in chronic HCV cases was not sex-related and were independent of the presence of cirrhosis or active schistosomiasis. In conclusions extrahepatic autoimmune disorders are widely prevalent in Egyptian chronic HCV patients. Strikingly high prevalence of anti-LKM1 Ab was noticed in our HCV cases which might be serotype - associated. Immunological disorders were not sex-related and are unlikely to be affected by the presence of cirrhosis or active schistosomiasis. Our findings might indicate the co-existence of autoimmune hepatitis and chronic HCV in our locality.
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