Prevalence and clinical relevance of serum autoantibodies in patients with chronic hepatitis C.
BACKGROUND
Chronic hepatitis C (CHC) is frequently associated with the presence of serum autoantibodies. The prevalence and clinical relevance of serum autoantibodies in CHC patients and their influence on antiviral treatment have not been well established.


METHODS
From February 1999 to July 2004, 460 consecutive adult patients with CHC were studied. Antinuclear antibody (ANA) and smooth muscle antibody (SMA) were determined by indirect immunofluorescence. The presence of these antibodies was related to patient characteristics and to the outcome of 24 weeks of therapy with interferon (IFN) alfa-2b (n=376) or pegylated- IFN alfa-2b (n=84) plus ribavirin.


RESULTS
The prevalence of ANA and SMA was 7.4% and 19.3%, respectively. Seropositivity for ANA and/or SMA was associated with old age and high aspartate aminotransferase (AST) levels. The rates of sustained virological response and early withdrawal of therapy were comparable between autoantibody- positive and -negative patients. None of the autoantibody-positive patients experienced a flare-up of transaminase during treatment, or developed severe systemic autoimmune disease.


CONCLUSIONS
Serum ANA and/or SMA-positive HCV-infected patients are older, and have higher disease activity and severity than their negative counterparts. However, the presence of ANA or SMA did not influence the response to combination antiviral therapy, which is safe and effective in autoantibody--positive CHC patients.
Chen
Chih-Hung
CH
Division of General Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Lee
Chuan-Mo
CM
Chen
Chien-Hung
CH
Hu
Tsung-Hui
TH
Wang
Jing-Houng
JH
Hung
Chao-Hung
CH
Chung
Ching-Hu
CH
Lu
Sheng-Nan
SN
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000410:Alanine Transaminase; C417083:peginterferon alfa-2b