Is autoimmune chronic active hepatitis a HCV-related disease?
We evaluated the specificity and clinical relevance of anti-hepatitis C virus antibody positivity in 22 HBsAg-negative patients with autoimmune (anti-nuclear, anti-actin or anti-liver-kidney microsomal antibody positive) chronic active hepatitis. An ELISA anti-HCV test and a recombinant immunoblot assay (RIBA-HCV) were used. Thirteen patients (59%) were anti-HCV positive and five (23%) anti-HCV negative by both ELISA and RIBA-HCV tests. Four patients (18%) were borderline positive by ELISA (OD less than 1.0), and three of them (all with severe disease) were negative by RIBA. Histologic necroinflammation, AST/ALT and gamma-globulins levels were higher and response to prednisolone treatment was better in RIBA anti-HCV-negative than in anti-HCV-positive cases. We confirmed with both RIBA and ELISA tests the high prevalence of anti-HCV already reported by ELISA in anti-nuclear and anti-liver-kidney microsomal antibody positive chronic active hepatitis. False positive for anti-HCV (i.e., a positive ELISA test not confirmed by RIBA) occurred only among patients with severe disease. Since RIBA-negative subjects showed the best response to corticosteroid, they might represent the only subset of cases of 'true' autoimmune chronic active hepatitis.
Magrin
S
S
Clinica Medica R, University of Palermo, Italy.
Craxì
A
A
Fiorentino
G
G
Fabiano
C
C
Provenzano
G
G
Pinzello
G B
GB
Palazzo
U
U
Almasio
P
P
Pagliaro
L
L
D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis; D000918:Antibody Specificity; D001327:Autoimmune Diseases / Q000097:blood* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D006521:Hepatitis, Chronic / Q000097:blood* / Q000276:immunology; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D005719:gamma-Globulins / Q000032:analysis
D000305:Adrenal Cortex Hormones; D000974:Antibodies, Antinuclear; D006508:Hepatitis Antibodies; D005719:gamma-Globulins