Antonaci Salvatore, Giannelli Gianluigi, Simone Barbara, Vella Francesco Saverio
Recenti Prog Med. 2005 Jan;96(1):27-31.
Non-organ specific autoantibodies are common in patients with chronic hepatitis C, making differential diagnosis difficult between viral, autoimmune forms and hepatitis C/autoimmune hepatitis overlap syndrome. The lack of additional criteria of autoimmunity in most patients leads to the definition of a "false" hepatitis C-autoimmune hepatitis overlap syndrome, while the "true" overlap syndrome occurs in a very few number of subjects. In patients with "false" overlap syndrome the first choice therapy is based on the administration of interferon plus ribavirin. On the contrary, first-line therapy with corticosteroids should be restricted to the "true" hepatitis overlap syndrome with the new therapeutic option of interferon/corticosteroid association.
非器官特异性自身抗体在慢性丙型肝炎患者中很常见,这使得在病毒性、自身免疫性肝炎形式与丙型肝炎/自身免疫性肝炎重叠综合征之间进行鉴别诊断变得困难。大多数患者缺乏自身免疫的其他标准,导致定义了一种“假性”丙型肝炎-自身免疫性肝炎重叠综合征,而“真性”重叠综合征仅发生在极少数患者中。对于“假性”重叠综合征患者,首选治疗方法是给予干扰素加利巴韦林。相反,皮质类固醇的一线治疗应仅限于“真性”肝炎重叠综合征,并采用干扰素/皮质类固醇联合的新治疗方案。