Non-organ-specific autoantibodies in chronic hepatitis c patients: association with histological activity and fibrosis

The interaction between HCV and the human immune system has attracted great interest in the last decade for two main reasons. Immune system related manifestations include a myriad of conditions ranging from sub-clinical cryoglobulinemia to overt lymphoproliferative malignancy. [Landau et al 2007]. Among the various immune system disorders associated with HCV infection is the auto immunity. Chronic hepatitis C virus [HCV] infection is, indeed, associated with a range of autoimmune manifestations, including increased expression of non organ-specific autoantibodies. There is ongoing debate as to whether the presence of autoantibodies provides additional information about the disease process or is simply an epiphenomenon. Aim to assess the prevalence, type of NOSA in chronic hepatitis € patients and to determine whether a relationship might exist between the presence of NOSA and the severity of liver disease in chronic hepatitis C. Methodology A total of one hundred patients with chronic hepatitis C who are treatment naive presented to the department of Hepatology; Ain Shams University hospitals between the years 2009 and 2011 were enrolled. Non-organ specific autoantibodies namely ASMA, ANA and LKM autoantibodies were assessed in the sera of all patients. A liver biopsy was also done to determine the histological degree of liver injury using Metavir score. We found that NOSAs were present in 14% of our cohort. ASMA was the most frequently detected autoantibody [13%] in this study and LKM was the least [4%] with predominately low titres [1:40]. NOSA was more common in females and the presence of autoantibodies was associated with higher level of transaminases and more advanced fibrosis and necroinflammatory scores on liver biopsy independent of the degree of viremia. NOSAs were associated with the most severe forms of chronic HCV infections