title: High prevalence of autoantibodies to C-reactive protein in patients with chronic hepatitis C infection: association with liver fibrosis and portal inflammation.
abstract: The presence of autoantibodies against C-reactive protein (anti-CRP) has been reported in association with autoimmunity and histopathology in chronic hepatitis C virus (HCV) infection. Resistin could play a role in the pathogenesis of hepatitis, although results on HCV infection are ambiguous. Here we retrospectively analyzed anti-CRP and resistin levels in the sera of 38 untreated and well-characterized HCV patients at the time of their first liver biopsy. HCV activity and general health were assessed by a physician at least yearly until follow-up ended. Anti-CRP and resistin were also measured in patients with autoimmune hepatitis (AIH) and nonalcoholic fatty liver disease (NAFLD). Anti-CRP antibodies were registered in all HCV patients, whereas only a few AIH (11%) and NAFLD (12%) sera were positive. Anti-CRP levels were related to histopathological severity and were highest in patients with cirrhosis at baseline. Resistin levels were similar in HCV, AIH, and NAFLD patients, but high levels of resistin were associated with early mortality in HCV patients. Neither anti-CRP nor resistin predicted a response to interferon-based therapy or cirrhosis development or was associated with liver-related mortality. We conclude that anti-CRP antibodies are frequently observed in chronic HCV infection and could be a useful marker of advanced fibrosis and portal inflammation.
authors.affiliation: Rheumatology/AIR, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. christopher.sjowall@liu.se
authors.forename: Christopher
authors.initials: C
authors.lastname: Sjöwall
authors.forename: Kristina
authors.initials: K
authors.lastname: Cardell
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Boström
authors.forename: Maria I
authors.initials: MI
authors.lastname: Bokarewa
authors.forename: Helena
authors.initials: H
authors.lastname: Enocsson
authors.forename: Mattias
authors.initials: M
authors.lastname: Ekstedt
authors.forename: Liselott
authors.initials: L
authors.lastname: Lindvall
authors.forename: Aril
authors.initials: A
authors.lastname: Frydén
authors.forename: Sven
authors.initials: S
authors.lastname: Almer
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000276:immunology*; D002097:C-Reactive Protein / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000276:immunology; D008103:Liver Cirrhosis / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000276:immunology* / Q000473:pathology; D011379:Prognosis; D052243:Resistin / Q000097:blood; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies
chemical_list: D001323:Autoantibodies; D052243:Resistin; D002097:C-Reactive Protein