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Author: G. VERUCCHI, M LENZI*, L ATTARD, P
MURATORI*, S DIOTALLEVI, R MINERO§, F GUZZO, F BIANCHI*, F
CHIODO Dep.of Clinical and Experimental-Division of Infectious
Diseases-University of Bologna, *Internal Medicine - University of
Bologna, § Dep. of Clinical Pathology- S.Orsola Hospital -
Bologna - Italy
The relationship between hepatitis virus infections (HCV and
HBV) and autoimmune phenomena (ANA, SMA, anti-LKM1, anti-LC1, a
ti-Thyroid-Peroxidase-anti-TPO and anti-Thyroglobulin-anti-TG) are
still poorly investigated in children. Aim of the study: to assess
the prevalence of non organ and organ specific autoantibodies in a
retrospective series of children with HCV and HBV-chronic
infection. Patients and Methods: 36 patients with anti-HCV and
HCV-RNA positive chronic hepatitis (18 males, 18 females) with a
median age of 8.9 years (range 2-15,8) were studied, Twenty-two
patients received blood or plasma transfusion, 11 were borm from
anti-HCV positive mothers,one had major surgery and in two the
route of infection was unknown. As a control group, sera from 42
children (23M/19F) (median age 9,4 years-range 2,5-15,11) with HBV
infection (33 HBV-DNA positive) were considered. Sera were tested
at a dilution of 1:20 on liver, kidney and stomach cryostat
sections and on Hep-2 cell. Anti-LC1 antibody was tested by CIE
with rat liver cytosol as source of antigen. Anti-Thyroid
Peroxidase and anti-Thyroglobulin antibodies were tested by a
commercially RIA-Kit. Results: non organ-specific autoantibodies
were detected in 10 out of 36 patients with HCV infection (28%) and
in 5 out of 42 children with HBV infection (12%). The prevalence of
each autoantibodies is shown in the table
HCV (36) HBV (42)
ANA (speckled) 1 3% 2 5%
SMA (non anti-actin) 5 14% 3 7%
Anti-LKM1 4 11% 0 -
Anti-LC1 0 - 0 -
Anti-TPO 1/29 3% 0/27 -
Anti-TG 0/29 - 0/27 -
Clinical and biochermical differences did not emerge between
autoantibodies positive and negative patients. No specific
association was found between HCV genotypes and one of the
autoantibodies studied. Four (3 SMA, 1 ANA) out of 12 patients with
HCV chronic hepatitis and 1 (ANA) out of 19 children with HBV
chronic hepatitis who underwent interferon therapy developed low
titres of autoantibodies under treatment. Conclusions: These
results demonstrate that overall prevalence of non organ specific
autoantibodies is higher in children with HCV -related chronic
hepatitis than that observed in HBV -related ones, and similar to
that observed in adults. The autoantibodies specificities typical
of autoimmune hepatitis were never observed in these patients.
Anti-LKM1 reactivity is specific of anti-HCV infection and its
prevalence is higher than that reported in adults.
Source: American Association for the Study of Liver Diseases
- 1996 Annual Meeting
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