title: Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?
abstract: 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.
authors.affiliation: Division of Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Rosilene G
authors.initials: RG
authors.lastname: Badiani
authors.forename: Vitória
authors.initials: V
authors.lastname: Becker
authors.forename: Renata M
authors.initials: RM
authors.lastname: Perez
authors.forename: Carla A L
authors.initials: CA
authors.lastname: Matos
authors.forename: Lara B
authors.initials: LB
authors.lastname: Lemos
authors.forename: Valéria P
authors.initials: VP
authors.lastname: Lanzoni
authors.forename: Luis Eduardo C
authors.initials: LE
authors.lastname: Andrade
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dellavance
authors.forename: Antonio Eduardo B
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia G
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: 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
chemical_list: D001323:Autoantibodies