Bai Li, Feng Zhen-ru, Lu Hai-ying, Li Wen-gang, Yu Min, Xu Xiao-yuan
Department of Infectious Diseases, Peking University First Hospital, Beijing, China.
Chin Med J (Engl). 2009 Jan 5;122(1):5-9.
Hepatitis C virus (HCV) infection may induce autoimmune response and autoantibodies can be detected in chronic hepatitis C (CHC) patients. However, the reported positive rate of autoantibodies in CHC patients in China varies considerably. In this study, we investigated the prevalence of antinuclear antibodies (ANA) and anti-liver-kidney-microsome type 1 autoantibodies (anti-LKM-1) in a large cohort of CHC patients, and analyzed the factors related to the presence of the autoantibodies.
A total of 360 CHC patients were enrolled in this study. Serum ANA and anti-LKM-1 were detected by indirect immunofluorescence and enzyme-linked immunosorbent assay, respectively. Clinical analysis was performed to disclose the related factors to autoantibody production.
The prevalence of ANA and anti-LKM-1 in CHC patients was 12.5% (45/360) and 2.5% (9/360), respectively. Women had a higher prevalence than men (18.9% vs 11.4%, P = 0.046). Patients with positive autoantibodies had lower HCV RNA levels (1.2 x 10(7) copies/L vs 7.2 x 10(7) copies/L, P < 0.05). Positive ANA was associated with higher serum globulin (P < 0.05). Stratified analysis showed that there were no significant differences in age, HCV genotype, disease course, clinical stage, prevalence of cirrhosis and interferon therapy between autoantibody-positive and -negative subgroups.
Autoantibodies can be induced in the course of CHC, and some CHC patients can even develop autoimmune hepatitis.
丙型肝炎病毒(HCV)感染可能诱发自身免疫反应,慢性丙型肝炎(CHC)患者可检测到自身抗体。然而,中国报道的CHC患者自身抗体阳性率差异很大。在本研究中,我们调查了一大群CHC患者中抗核抗体(ANA)和抗肝肾微粒体1型自身抗体(抗-LKM-1)的患病率,并分析了与自身抗体存在相关的因素。
本研究共纳入360例CHC患者。分别采用间接免疫荧光法和酶联免疫吸附测定法检测血清ANA和抗-LKM-1。进行临床分析以揭示自身抗体产生的相关因素。
CHC患者中ANA和抗-LKM-1的患病率分别为12.5%(45/360)和2.5%(9/360)。女性患病率高于男性(18.9%对11.4%,P = 0.046)。自身抗体阳性的患者HCV RNA水平较低(1.2×10⁷拷贝/升对7.2×10⁷拷贝/升,P < 0.05)。ANA阳性与血清球蛋白升高相关(P < 0.05)。分层分析显示,自身抗体阳性和阴性亚组在年龄、HCV基因型、病程、临床分期、肝硬化患病率和干扰素治疗方面无显著差异。
CHC病程中可诱发自身抗体,部分CHC患者甚至可发展为自身免疫性肝炎。