Hepatitis C virus replication in 'autoimmune' chronic hepatitis.
Both high and low anti-hepatitis C virus antibody (anti-HCV) prevalence has been reported in autoimmune chronic active hepatitis. Therefore, we studied 15 consecutive HBsAg-negative, ELISA anti-HCV-positive, autoantibody-positive patients with biopsy proven chronic active hepatitis in order to confirm ELISA specificity by immunoblot test (RIBA-HCV), and to evaluate HCV replication by serum HCV-RNA. Nine patients were anti-nuclear, three type 1 anti-liver-kidney microsomal and three anti-smooth muscle antibody positive. None had associated autoimmune disease. All cases showed mild clinical disease and only moderate necroinflammatory activity. Response to prednisone was poor. RIBA-HCV confirmed ELISA results in all patients. HCV-RNA was found in the serum from 10 patients. Institution of alpha-interferon treatment in three steroid non-responsive patients was followed by prompt normalization of transaminases. Thus, a subgroup of autoantibody-positive chronic active hepatitis can be recognized as HCV-related and should be clinically and etiologically distinguished from autoimmune chronic active hepatitis. Trials of alpha-interferon treatment are worthwhile in this condition.
Magrin
S
S
Clinica Medica R, University of Palermo, Italy.
Craxi
A
A
Fabiano
C
C
Fiorentino
G
G
Almasio
P
P
Palazzo
U
U
Pinzello
G
G
Provenzano
G
G
Pagliaro
L
L
Choo
Q L
QL
D001323:Autoantibodies / Q000032:analysis*; D001483:Base Sequence; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D006505:Hepatitis / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000175:diagnosis* / Q000276:immunology; D018937:Hepatitis C Antibodies; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009838:Oligodeoxyribonucleotides; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D014779:Virus Replication
D001323:Autoantibodies; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D009838:Oligodeoxyribonucleotides; D012367:RNA, Viral