Division of Gastroenterology, Hepatitis Section, Federal University of Sao Paulo, Sao Paulo, Brazil.
Eur J Gastroenterol Hepatol. 2009 Apr;21(4):350-6. doi: 10.1097/MEG.0b013e3283089392.
Serum autoantibodies such as antinuclear antibody (ANA) are frequently detected in patients with chronic hepatitis C virus (HCV) infection, but its relevance is a matter of discussion.
To assess the association of ANA positivity with clinical and histological features, and with the outcome of antiviral therapy in patients with HCV infection.
Baseline samples from patients with hepatitis C treated with interferon and ribavirin were tested for ANA positivity by indirect immunofluorescence.
The mean age was 48.3+/-11.1 years and 56% were men. Among 234 included patients, 22 patients (9.4%) were positive for ANA. These patients showed significantly higher median alanine aminotransferase level (3.52 vs. 2.39 x upper limit of normal, P=0.009) when compared with ANA-negative patients. Fibrosis stage and necroinflammatory grading were not influenced by ANA positivity. Sustained virological response (SVR) rates were similar between ANA-positive and ANA-negative patients (27 vs. 29%, P=0.882). Alanine aminotransferase flares (> or = 1.5-fold the baseline) during treatment were observed in 28 patients (12%), irrespective of the presence of ANA and without any clinical significance.
Among HCV patients, ANA positivity seems to represent an immunological epiphenomenon. It neither influences clinical, biochemical, and histological features of chronic hepatitis C nor predicts response to antiviral treatment.
慢性丙型肝炎病毒 (HCV) 感染患者常检测到血清自身抗体，如抗核抗体 (ANA)，但其相关性仍存在争议。
评估 ANA 阳性与临床和组织学特征的相关性，以及与 HCV 感染患者抗病毒治疗结局的关系。
用间接免疫荧光法检测接受干扰素和利巴韦林治疗的丙型肝炎患者的基线样本中 ANA 阳性。
平均年龄为 48.3±11.1 岁，56%为男性。在 234 例纳入患者中，有 22 例（9.4%）ANA 阳性。与 ANA 阴性患者相比，这些患者的中位丙氨酸氨基转移酶水平显著更高（3.52 vs. 2.39 x 正常值上限，P=0.009）。纤维化分期和坏死性炎症分级不受 ANA 阳性影响。ANA 阳性和 ANA 阴性患者的持续病毒学应答 (SVR) 率相似（27% vs. 29%，P=0.882）。治疗期间观察到 28 例（12%）患者丙氨酸氨基转移酶升高（基线的 1.5 倍以上），与 ANA 存在与否无关，也无任何临床意义。
在 HCV 患者中，ANA 阳性似乎代表一种免疫性偶发现象。它既不影响慢性丙型肝炎的临床、生化和组织学特征，也不能预测抗病毒治疗的反应。
