title: Expression and clinical significance of antinuclear antibody in hepatitis C virus infection.
abstract: BACKGROUND
  The prevalence of antinuclear antibody (ANA) has been documented in patients with hepatitis C virus (HCV) infection. We attempted to determine the titer and to characterize the patterns and clinical significance of ANA in HCV infection.
  
  
  METHODS
  Forty-eight consecutive patients with positive anti-HCV antibody and positive HCV RNA were included in this study. Sera from patients were tested for ANA and anti-smooth muscle antibody by indirect immunofluorescence. Serum aminotransferase, alkaline phosphatase, alpha-fetoprotein, and cryoglobulin levels also were determined.
  
  
  RESULTS
  Eleven (23%) of 48 HCV-infected patients were positive for ANA. Antinuclear antibody revealed speckled pattern in 10 (91%) of the 11 ANA-positive HCV-infected patients. Twenty (54%) of 37 ANA-negative HCV-infected patients had detectable pattern with equivocal titer (titer <1.5). The ANA pattern was speckled in all 20 patients. Hepatitis C virus-infected patients with positive ANA were older than the HCV-infected patients with negative ANA (62.90 +/- 11.05 years vs. 56.46 +/- 14.94 years, respectively; p < 0.1). Serum levels of aspartate aminotransferase (39.36 +/- 14.98 IU/L vs. 30.70 +/- 23.15 IU/L, p < 0.05), alkaline phosphatase (189.00 +/- 75.63 IU/L vs. 122.41 +/- 40.88 IU/L, p < 0.01), and alpha-fetoprotein (47.72 +/- 80.47 pg/dL vs. 7.00 +/- 8.28 pg/dL, p < 0.01) were higher in ANA-positive HCV-infected patients than in ANA-negative HCV-infected patients, respectively. There were no significant differences in gender, alanine aminotransferase, anti-smooth muscle antibody, or cryoglobulin between the two groups.
  
  
  CONCLUSIONS
  Antinuclear antibody was present in 11 (23%) of 48 patients with HCV infection in our study. Speckled pattern is the major expression pattern of ANA in HCV infection. Antinuclear antibody-positive HCV-infected patients have significantly higher serum aspartate aminotransferase, alkaline phosphatase, and alpha-fetoprotein levels than ANA-negative HCV-infected patients.
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Y C
authors.initials: YC
authors.lastname: Peng
authors.forename: S C
authors.initials: SC
authors.lastname: Hsieh
authors.forename: D Y
authors.initials: DY
authors.lastname: Yang
authors.forename: C F
authors.initials: CF
authors.lastname: Tung
authors.forename: W H
authors.initials: WH
authors.lastname: Hu
authors.forename: W N
authors.initials: WN
authors.lastname: Huang
authors.forename: G H
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001219:Aspartate Aminotransferases / Q000097:blood; D003450:Cryoglobulins / Q000032:analysis; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006526:Hepatitis C / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000974:Antibodies, Antinuclear; D003450:Cryoglobulins; D018937:Hepatitis C Antibodies; D000509:alpha-Fetoproteins; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase