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Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance
Author(s) -
Yee L. J.,
Kelleher P.,
Goldin R. D.,
Marshall S.,
Thomas H. C.,
Alberti A.,
Chiaramonte M.,
Braconier J.H.,
Hall A. J.,
Thursz M. R.
Publication year - 2004
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2004.00530.x
Subject(s) - anti nuclear antibody , medicine , gastroenterology , hepatitis c virus , antibody , odds ratio , hepatitis c , immunology , fibrosis , virus , autoantibody
Summary. We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden ( n = 225), the UK ( n = 207) and Italy ( n = 213) were evaluated by indirect immunofluorescence on Hep‐2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46–0.94; P = 0.023]. Duration of HCV infection, age at infection, current age, route of infection, viral genotype, alcohol consumption, fibrosis stage and inflammatory score were not correlated with ANA+ or ANA pattern. Female gender was correlated with ANA+ and this association persisted in multivariable analyses (OR = 3.0; P = 0.002). Increased plasma cells were observed in the liver biopsies of ANA‐positive individuals compared with ANA‐negative individuals, while a trend towards decreased lymphoid aggregates was observed [hazard ratio (HR) = 9.0, P = 0.037; HR = 0.291, P = 0.118, respectively]. No correlations were observed between ANA positivity and nonresponse to therapy (OR = 1.4; P = 0.513), although ANA+ was correlated with faster rates of liver fibrosis, this was not statistically significant (OR = 1.8; P = 0.1452). Low titre ANA+ should not be a contraindication for interferon treatment. Our observation of increased plasma cells in ANA+ biopsies might suggest B‐cell polyclonal activity with a secondary clinical manifestation of increased serum immunoglobulins.