title: Antinuclear antibody positivity in patients with chronic hepatitis C: clinically relevant or an epiphenomenon?
abstract: BACKGROUND
  Serum autoantibodies such as antinuclear antibody (ANA) are frequently detected in patients with chronic hepatitis C virus (HCV) infection, but its relevance is a matter of discussion.
  
  
  OBJECTIVE
  To assess the association of ANA positivity with clinical and histological features, and with the outcome of antiviral therapy in patients with HCV infection.
  
  
  METHODS
  Baseline samples from patients with hepatitis C treated with interferon and ribavirin were tested for ANA positivity by indirect immunofluorescence.
  
  
  RESULTS
  The mean age was 48.3+/-11.1 years and 56% were men. Among 234 included patients, 22 patients (9.4%) were positive for ANA. These patients showed significantly higher median alanine aminotransferase level (3.52 vs. 2.39 x upper limit of normal, P=0.009) when compared with ANA-negative patients. Fibrosis stage and necroinflammatory grading were not influenced by ANA positivity. Sustained virological response (SVR) rates were similar between ANA-positive and ANA-negative patients (27 vs. 29%, P=0.882). Alanine aminotransferase flares (> or = 1.5-fold the baseline) during treatment were observed in 28 patients (12%), irrespective of the presence of ANA and without any clinical significance.
  
  
  CONCLUSIONS
  Among HCV patients, ANA positivity seems to represent an immunological epiphenomenon. It neither influences clinical, biochemical, and histological features of chronic hepatitis C nor predicts response to antiviral treatment.
authors.affiliation: Division of Gastroenterology, Hepatitis Section, Federal University of Sao Paulo, Sao Paulo, Brazil. janaina.narciso@uol.com.br
authors.forename: Janaína L
authors.initials: JL
authors.lastname: Narciso-Schiavon
authors.forename: Fernanda Caruso F
authors.initials: FC
authors.lastname: Freire
authors.forename: Marcelo Mendes
authors.initials: MM
authors.lastname: Suarez
authors.forename: Marcus Vinícius O
authors.initials: MV
authors.lastname: Ferrari
authors.forename: Gustavo Quirino
authors.initials: GQ
authors.lastname: Scanhola
authors.forename: Leonardo de Lucca
authors.initials: Lde L
authors.lastname: Schiavon
authors.forename: Roberto J de
authors.initials: RJ
authors.lastname: Carvalho Filho
authors.forename: Maria Lucia G
authors.initials: ML
authors.lastname: Ferraz
authors.forename: Antonio Eduardo B
authors.initials: AE
authors.lastname: Silva
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood* / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000974:Antibodies, Antinuclear; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons; D000410:Alanine Transaminase