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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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Copyright 2002 Egyptian Association of Immunologists .
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