Serum autoantibodies in chronic hepatitis C: influence on disease profile

ABSTRACT

Non-organ-specific autoantibodies [NOSAs] are commonly detected in chronic hepatitis C [CHC] bat their significance remain on debate. To determine the prevalence of anti-nuclear [ANA], anti-smooth muscle [ASMA] and anti-liver kidney microsomes type 1 [anti-LKM1] antibodies and assess their association with patient demographics, biochemical and histological parameters of disease activity and response to antiviral therapy. One hundred and thirty naive chronic hepatitis C [CHC] patients were included. Clinical demographic and laboratory data at the time of liver biopsy were obtained. All cases were screened for autoantibodies by an enzyme linked immanosorbent assay [ELISA]. A pathologist reviewed all pathologic specimens using the modified histological activity index [HAL] of Ishak. All patients received combined antiviral therapy in the form of Pegylated Interferon alpha 2a-l60 micro g plus Ribavirin. Non-organ-specific autoantibodies [NOSAs] were observed in 38 patients [29.23%] ANA in 25 [19.23%], ASMA in 18 [13.85%] and anti-LKM1 was the rarest occurring in only two CHC patients [1.54%]. Concomitant positivity for ANA and ASMA was observed in 7 of these 38 cases [5.38%]. The presence of NOSAs was associated with higher aspartate trasaminase [AST], alanine trasaminase [ALT] and gamma-globulin. There was a significant association between seropositivity of NOSAs and higher histological activity score of inflammation and hepatocellubr injury [P=0.024] and with increased plasma cell infiltrate [P=0.000]. In contrast, no differences were observed regarding age, gender, viral load, stage of fibrosis and response to combined antiviral therapy. The presence of non-organ-specific autoantibodies [NOSAs] in CHC is associated with more necroinflammatory grade without increased degree of fibrosis or failure of combined antiviral therapy