Identification of hepatitis A virus as a trigger for autoimmune chronic hepatitis type 1 in susceptible individuals.
To identify factors contributing to the pathogenesis of autoimmune chronic active hepatitis (CAH) healthy relatives of 13 patients with the disorder were followed prospectively for 4 years. 58 relatives were monitored for various serological markers and for T-lymphocyte migration inhibitory activity every 2 months. 3 cases of subclinical acute hepatitis A occurred during the study. In 2 of the 3 subjects, before hepatitis A virus (HAV) infection, there was a defect in suppressor-inducer T lymphocytes specifically controlling immune responses to the asialoglycoprotein receptor, an antigen expressed on the hepatocyte surface. In these 2 subjects, specific helper T cells and antibodies to the asialoglycoprotein receptor persisted and increased after acute hepatitis A, and autoimmune CAH type 1 developed within 5 months. Thus, in susceptible individuals HAV is a trigger for autoimmune CAH.
Infectious Diseases Unit, A. Pugliese Hospital, Catanzaro, Italy.
S
S
Vento
T
T
Garofano
G
G
Di Perri
L
L
Dolci
E
E
Concia
D
D
Bassetti
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000096:biosynthesis / Q000097:blood; D037263:Asialoglycoprotein Receptor; D001327:Autoimmune Diseases / Q000276:immunology* / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D006506:Hepatitis A / Q000276:immunology* / Q000382:microbiology; D006521:Hepatitis, Chronic / Q000276:immunology* / Q000382:microbiology; D006507:Hepatovirus / Q000502:physiology*; D006801:Humans; D007961:Leukocyte Migration-Inhibitory Factors / Q000502:physiology; D011446:Prospective Studies; D011971:Receptors, Immunologic / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000502:physiology; D050378:T-Lymphocytes, Regulatory / Q000502:physiology
D000914:Antibodies, Viral; D037263:Asialoglycoprotein Receptor; D015415:Biomarkers; D007961:Leukocyte Migration-Inhibitory Factors; D011971:Receptors, Immunologic; D000410:Alanine Transaminase