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TITLE: Autoantibody prevalence in children with
liver disease due to chronic hepatitis C virus (HCV) infection
Abstract:
HCV infection and interferon-alpha (IFN-alpha) therapy have been
associated with autoimmunity. To assess whether chronic liver
disease (CLD) due to HCV infection or its treatment with IFN-alpha
cause autoimmune manifestations, the prevalence of tissue
autoantibodies in 51 children with chronic HCV infection and 84
with other CLD was analysed by standard techniques. Sixty-five
percent of patients with chronic HCV infection, 66% with chronic
hepatitis B infection and 60% with Wilson's disease were positive
for at least one autoantibody. In the 51 subjects with chronic HCV
infection (29 treated with IFN-alpha, 22 untreated), tested on 165
occasions over a median of 9 months (range 5-42 months),
autoantibodies to nuclei (ANA), smooth muscle (SMA), gastric
parietal cell (GPC) and/or liver kidney microsomal type 1 (LKM-1)
were similarly prevalent in treated and untreated patients (90%
versus 68%, P= 0.12). Positivity for SMA was present in 67%, GPC in
32%, ANA in 10%, LKM-1 in 8% of cases. Treatment with IFN-alpha had
to be suspended due to transaminase elevation in one SMA-positive,
one ANA-positive but in three of four LKM-1-positive patients. Our
results show that: (i) autoantibodies are common in viral-induced
hepatitis and Wilson's disease; (ii) positivity for SMA, GPC, ANA
is part of the natural course of chronic HCV infection, their
prevalence being unaffected by IFN-alpha; and (iii)IFN-alpha should
be used cautiously in the treatment of LKM-1/HCV-positive
patients.
AUTHOR: Gregorio GV, Pensati P, Iorio R, Vegnente A,
Mieli-Vergani G, Vergani D; SOURCE: CLINICAL AND EXPERIMENTAL
IMMUNOLOGY 112: (3) 471-476 JUN 1998
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