Detection of HCV-RNA in paraffin-embedded liver biopsies from patients with autoimmune hepatitis.
OBJECTIVE
There may be a relationship between autoimmune hepatitis and viral infection. To examine this relationship, 19 patients with autoimmune hepatitis and/or chronic hepatitis C were studied.


METHODS
Patients were selected initially on the basis of having autoantibodies (anti-nuclear, anti-smooth muscle, or anti-liver-kidney microsomal) in serum. Formalin-fixed, paraffin-embedded liver biopsies from these patients were tested for HCV-RNA by polymerase chain reaction. The biopsies were examined histologically to detect features suggestive of chronic hepatitis C or autoimmune hepatitis. The results were correlated with serum anti-HCV and HCV-RNA, and with response to steroid therapy.


RESULTS
Five of the nineteen patients had detectable HCV-RNA in their liver biopsies. In two of three patients from whom serum was available, HCV-RNA was detectable. The remaining 14 patients were negative for HCV-RNA by tissue polymerase chain reaction. Serum was available from 11 of these patients, and serum HCV-RNA was negative in all. All of the three HCV-RNA-positive patients who were treated with steroids showed a partial response; tissue positivity for HCV-RNA was significantly higher in partial responders than in complete responders (60% vs 0%, p = 0.01). Severe portal and periportal inflammation with prominent plasma cells together with bridging parenchymal necrosis were seen more often in HCV-negative biopsies. Mild portal and periportal inflammation with portal lymphoid aggregates, apoptosis and spotty parenchymal necrosis were seen more in HCV-positive biopsies.


CONCLUSIONS
These results show that hepatitis C virus can be detected in some patients with circulating autoantibodies. The ability to detect HCV-RNA in paraffin-embedded archival material provides a valuable addition to the battery of available HCV tests.
Savage
K
K
Academic Department of Histopathology, Royal Free Hospital, London, United Kingdom.
Dhillon
A P
AP
Schmilovitz-Weiss
H
H
el-Batanony
M
M
Brown
D
D
Dusheiko
G
G
Scheuer
P J
PJ
D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000821:virology*; D001483:Base Sequence; D001706:Biopsy; D002648:Child; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D006505:Hepatitis / Q000821:virology*; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015335:Molecular Probes / Q000235:genetics; D008969:Molecular Sequence Data; D016612:Paraffin Embedding; D012367:RNA, Viral / Q000378:metabolism*
D015335:Molecular Probes; D012367:RNA, Viral