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Objective To investigate the changes of autoantibodies in hepatitis B disease and its clinical sig-nificance.Methods 418 cases of hepatitis B patients were selected as hepatitis B group.At the same time,148 hos-pitalized patients in our hospital with autoimmune hepatitis( AIH) were chosen as AIH group.And 100 healthy people with physical examination were selected as control group at the same time .The antinuclear antibodies , anti -smooth muscle antibody( SMA) and anti-kidney microsomal antibodies and other autoantibodies of the three groups were detected and analyzed statistically.Results ANA-positive rate of hepatitis B group was 22.73%,ANA titer was mainly 1:100,only two cases of liver cirrhosis titers were 1:320,ANA karyotype was mainly homogenous,only four cases belonged speckled pattern;ANA positive rate of AIH patients was 60.14%,ANA titer was mainly 1:320,or even 1:1 000, primarily as a spot -type karyotype, nucleolar and centromere type.Differences between the two groups were statistically significant (P<0.05).The positive rates of hepatitis B,chronic hepatitis,severe hepatitis B and hepatitis B patients with cirrhosis ANA were significantly higher than in patients with acute hepatitis B,the differ-ences were statistically significant (χ2 =12.172,12.560,28.123,all P<0.05).Compared with AIH group,the posi-tive rate of SMA and LKM in patients with hepatitis decreased 51.98%,32.22%,respectively,the differences were statistically significant (χ2 =196.843,107.357,all P<0.05).The positive rate of hepatitis B level ANA ( +) patients of ALT and AST,HBV DNA was significantly higher than ANA (-) group.The level of hepatitis B patients ALT and AST,HBV DNA positive group were significantly higher than AIH.Differences were statistically significant (all P<0.05).Conclusion Autoantibody detection helps to study autoimmune etiology and pathogenesis of great importance for patients with hepatitis B and cirrhosis,but the reaction involved in the pathogenesis of autoimmune hepatitis level research still needs to be deeper.
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BACKGROUND/AIMS: Exclusion of liver disease from other causes such as autoimmune hepatitis is necessary for diagnosis of nonalcoholic fatty liver disease (NAFLD). However, there has been no study on the prevalence and significance of autoantibodies in the patients with clinically suspected NAFLD in Korea, where hepatitis B is endemic and autoimmune hepatitis is relatively uncommon. METHODS: We prospectively tested for anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-mitochondrial antibody (AMA) in 135 serially enrolled patients with suspected NAFLD. We compared the clinical characteristics and biochemical indices of the ANA-positive or ASMA-positive group with those of the autoantibody-negative group. RESULTS: Sixteen patients (11.8%) had serum autoantibodies; there was ANA in 8 patients (5.9%), ASMA in 7 (5.1%), and AMA in 2 (1.5%). Both ANA and AMA were positive in one patient. The ANA-positive or ASMA-positive group showed an older age (49.5+/-13.0 vs. 42.0+/-10.9 years, respectively, P=0.018) and higher levels of serum globulin (3.1+/-0.4 vs. 2.9+/-0.4 g/dL, respectively, P=0.037), compared with the autoantibody-negative group. Two cases with positive ANA or ASMA fulfilled the diagnostic criteria for probable autoimmune hepatitis and two cases with positive AMA were suspected as primary biliary cirrhosis. CONCLUSIONS: These findings suggest that autoantibodies could be found in some patients with suspected NAFLD in Korea, AMA-positivity or ASMA-positivity could be associated with old age and high serum globulin, and some of the autoantibody-positive cases could be diagnosed as autoimmune hepatitis or primary biliary cirrhosis. Further studies are necessary to clarify the clinical significance of autoantibody positivity in those patients.