Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?
OBJECTIVE
To evaluate the overlap of autoimmune hepatitis in hepatitis C virus (HCV)-infected patients with intense interface hepatitis.


METHODS
Among 1759 patients with hepatitis C submitted to liver biopsy, 92 (5.2%) presented intense interface hepatitis. These patients were evaluated regarding the presence of antinuclear antibody (ANA), anti-smooth muscle antibody (SMA) and anti-liver/kidney microsomal antibody (LKM-1), levels of gamma-globulin and histological findings related to autoimmune hepatitis (plasma cell infiltrate and presence of rosettes).


RESULTS
Among patients with hepatitis C and intense interface hepatitis there was a low prevalence of autoantibodies (ANA = 12%, SMA = 5%, LKM-1 = 0%) and the median gamma-globulin level was within the normal range. Typical histological findings of autoimmune disease were observed in only two cases (2%). After applying the score for diagnosis of autoimmune hepatitis, only one patient was classified with a definitive diagnosis of autoimmune hepatitis. Since overlap with autoimmune hepatitis was not the explanation for the intense necroinflammatory activity in patients with chronic hepatitis C we sought to identify the variables associated with this finding. The presence of intense interface hepatitis was associated with more advanced age, both at the time of infection and at the time of the biopsy, and higher prevalence of blood transfusion and alcohol abuse.


CONCLUSIONS
Although possible, overlap with autoimmune hepatitis is a very rare association in HCV-infected patients with intense interface hepatitis, an unusual presentation which seems to be related to other host variables.
Badiani
Rosilene G
RG
Division of Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Brazil.
Becker
Vitória
V
Perez
Renata M
RM
Matos
Carla A L
CA
Lemos
Lara B
LB
Lanzoni
Valéria P
VP
Andrade
Luis Eduardo C
LE
Dellavance
Alessandra
A
Silva
Antonio Eduardo B
AE
Ferraz
Maria Lucia G
ML
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
D001323:Autoantibodies