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Hepatitis C virus‐related autoimmunity in patients with porphyria cutanea tarda
Author(s) -
FERRI C.,
BAICCHI U.,
CIVITA L. LA,
GRECO F.,
LONGOMBARDO G.,
MAZZONI A.,
CARECCIA G.,
BOMBARDIERI S.,
PASERO G.,
ZIGNEGO A. L.,
MANNS M. P.
Publication year - 1993
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1993.tb00741.x
Subject(s) - porphyria cutanea tarda , medicine , hepatitis c virus , immunology , rheumatoid factor , hepatitis c , autoimmunity , cryoglobulinemia , hepatitis , serology , antibody , liver biopsy , autoimmune hepatitis , cryoglobulins , virology , virus , biopsy
. Hepatitis C virus (HCV) infection is frequently found in autoimmune hepatitis and mixed cryoglobulinaemia. In these conditions HCV could be responsible for immuno‐mediated organ alterations. The aim of this study was to evaluate the presence of immunological alterations in PCT patients, in which HCV infection has been frequently found. Twenty‐three PCT patients were evaluated for clinical and serological alterations, including: chronic hepatitis, other systemic symptoms, serum cryoglobulins and rheumatoid factor (RF), haemolytic complement, serum immunoglobulins, anti‐nuclear (ANA), anti‐smooth muscle (ASMA), anti‐liver‐kidney‐microso‐mal (anti‐LKMl), anti‐soluble‐liver‐antigen (SLA), anti‐mitochondrial (AMA), anti‐GOR antibodies, anti‐HCV and HCV RNA. Abnormal serum ALT were present in the majority of cases (20/23, 87%), while liver biopsy revealed a chronic persistent hepatitis or chronic active hepatitis in 15/20 (75%) PCT patients. In a high percentage of subjects (91%) the presence of anti‐HCV was detected by ELISA and RIBA II (Chiron, Emeryville CA, USA). In 17/22 (77%) cases the ongoing HCV replication in the serum was demonstrated by the detection of HCV genomes (polymerase chain reaction). The prevalence of both anti‐HCV and HCV RNA in PCT was significantly higher if compared to 22 systemic immunological diseases ( P< 0.00l) and 47 healthy subjects ( P<0.001 ). A possible HCV‐induced autoimmunity in PCT was suggested by the presence of the following immunological parameter alterations: anti‐GOR in 13/23 (57%), ANA in 4/23 (17%), ASMA in 18/23 (78%), anti‐LKMI in 1/23 (4%), RFin 23/23 (100%), mixed cryoglobulins in 4/23 (170/0), complement consumption in 10/23 (43%). The high prevalence of HCV infection and various immunological abnormalities suggest that HCV in combination with other factors (genetic, alcohol, etc.) could play a relevant role in the pathogenesis of hepatic and metabolic alterations of PCT.