Acay Akif, Demir Kasim, Asik Gulsah, Tunay Havva, Acarturk Gursel
Akif Acay, Department of Internal Medicine, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
Kasim Demir, Department of Gastroenterology, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
Pak J Med Sci. 2015 Jan-Feb;31(1):150-4. doi: 10.12669/pjms.311.6053.
To examine the occurrence frequency of auto-antibodies and autoimmune diseases in patients with chronic hepatitis B or C.
A total of 67 patients diagnosed with chronic hepatitis B and 77 patients diagnosed with chronic hepatitis C infection based on HBs Ag, Anti HCV, HBe Ag, Anti HBe Ag, HBV DNA, HCV RNA, liver ultrasound, and liver biopsy results as well as 48 healthy individuals were included in this study. ANA, anti dsDNA, anti LKM, Anti-SMA, AMA, C-ANCA, P-ANCA, anti-SSA, anti-SSB, anti-Scl-70, anti Jo-1, anti-U1snRNP, anti-centromere, anti-Jo-1, anti tpo, and anti tg were studied in all individuals in each study group.
ANA positivity was detected in 8 (12%), 15 (19%) and 2 (4%) individuals in HBV, HCV and control groups, respectively. The difference between the groups was significant (P=0.04). Similarly, anti Tg was positive in one subject in HBV group, in 6 subjects (7%) in HCV group, and in one subject among controls, the difference being significant (P=0.04). There were no significant differences between the study groups in the frequency of other auto-antibodies.
Similar to studies involving patients who received interferon and/or antiviral agents, an increased frequency of auto-antibodies was also detected in our patient group consisting of interferon and anti-viral naive subjects. The increase in the frequency of auto-antibodies reached statistical significance among individuals with HCV infection. Thus, pre-treatment assessment of auto-antibodies in newly diagnosed cases of chronic hepatitis B or hepatitis C infection may provide beneficial information on the future occurrence of auto-immune responses in these patients.
研究慢性乙型肝炎或丙型肝炎患者自身抗体及自身免疫性疾病的发生频率。
本研究纳入了67例根据乙肝表面抗原（HBs Ag）、抗丙型肝炎病毒（Anti HCV）、乙肝e抗原（HBe Ag）、抗乙肝e抗原（Anti HBe Ag）、乙肝病毒脱氧核糖核酸（HBV DNA）、丙型肝炎病毒核糖核酸（HCV RNA）、肝脏超声及肝活检结果诊断为慢性乙型肝炎的患者和77例诊断为慢性丙型肝炎感染的患者，以及48名健康个体。对各研究组的所有个体检测抗核抗体（ANA）、抗双链脱氧核糖核酸（anti dsDNA）、抗肝肾微粒体抗体（anti LKM）、抗平滑肌抗体（Anti-SMA）、抗线粒体抗体（AMA）、胞浆型抗中性粒细胞胞浆抗体（C-ANCA）、核周型抗中性粒细胞胞浆抗体（P-ANCA）、抗干燥综合征A抗原抗体（anti-SSA）、抗干燥综合征B抗原抗体（anti-SSB）、抗硬皮病-70抗体（anti-Scl-70）、抗组氨酰tRNA合成酶抗体（anti Jo-1）、抗U1核糖核蛋白抗体（anti-U1snRNP）、抗着丝点抗体、抗组氨酰tRNA合成酶抗体（anti-Jo-1）、抗甲状腺过氧化物酶抗体（anti tpo）和抗甲状腺球蛋白抗体（anti tg）。
乙肝组、丙肝组和对照组中分别有8例（12%）、15例（19%）和2例（4%）个体检测到ANA阳性。组间差异具有统计学意义（P = 0.04）。同样，乙肝组1例个体、丙肝组6例（7%）个体及对照组1例个体的抗甲状腺球蛋白抗体呈阳性，差异具有统计学意义（P = 0.04）。其他自身抗体的频率在各研究组之间无显著差异。
与涉及接受干扰素和/或抗病毒药物治疗患者的研究相似，在我们由未接受过干扰素和抗病毒药物治疗的个体组成的患者组中也检测到自身抗体频率增加。自身抗体频率的增加在丙型肝炎感染个体中具有统计学意义。因此，对新诊断的慢性乙型肝炎或丙型肝炎感染病例进行自身抗体的治疗前评估，可能为这些患者未来自身免疫反应的发生提供有益信息。
