State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Department of Laboratory Medicine, The First People's Hospital of Yancheng City, Yancheng, People's Republic of China.
Emerg Microbes Infect. 2020 Feb 10;9(1):332-340. doi: 10.1080/22221751.2020.1722759. eCollection 2020.
The seroprevalenc of autoimmune hepatitis (AIH)-related antibodies in patients, particularly Asians, with acute hepatitis E (AHE) is unclear. In this study, we investigated whether acute hepatitis E virus (HEV) infection is associated with the seroprevalence of AIH-related autoantibodies and assessed their impact on the disease characteristics. AIH-related autoantibodies were detected by indirect immunofluorescence in 198 AHE patients and 50 type 1 AIH patients. The positivity rates of against nuclear antigen (ANA) and smooth muscles antibody (SMA) in AHE patients were 37.4% and 22.7%, and the total positivity rate was 50%. Compared to those in AIH patients, the positivity rates of ANA-H and SMA-AA were significantly lower (35.1% vs. 82.1% and 4.4% vs. 88.4%). Female gender and the ALT level, but not immunosuppressive or antiviral drugs, were independently predictive of the presence of AIH-related autoantibodies in AHE patients. Fifty-two patients positive for AIH-related autoantibodies were followed up for 12 months. During this period, 33 of them became negative and 19 remained positive, albeit with significantly decreased titres. In conclusions, the seroprevalence of AIH-related autoantibodies in AHE patients was elevated, particularly in females, but their subspecificities and titres differed from those of type 1 AIH. Acute HEV infection may be related to AIH. AIH: autoimmune hepatitis; AHE: acute hepatitis E; ANA: against nuclear antigen; SMA: smooth muscles antibody; ANA-H: ANA with homogeneous pattern; SMA-AA: SMA with anti-actin pattern; Anti-LKM1: anti- liver-kidney microsomes-1 antibody; ANCA: anti-neutrophil cytoplasmic antibody; AMA: anti-mitochondrial antibody; Anti-SLA: anti-soluble liver antigen; Anti-LC1: anti-liver cytoplasmic type 1 antibody; pANCA: perinuclear antineutrophil cytoplasmic antibody.
自身免疫性肝炎（AIH）相关抗体在急性戊型肝炎（AHE）患者中的血清流行率尚不清楚，特别是在亚洲人群中。本研究旨在探讨急性戊型肝炎病毒（HEV）感染是否与 AIH 相关自身抗体的血清流行率相关，并评估其对疾病特征的影响。在 198 例 AHE 患者和 50 例 1 型 AIH 患者中通过间接免疫荧光法检测 AIH 相关自身抗体。AHE 患者抗核抗体（ANA）和抗平滑肌抗体（SMA）的阳性率分别为 37.4%和 22.7%，总阳性率为 50%。与 AIH 患者相比，ANA-H 和 SMA-AA 的阳性率明显较低（35.1%比 82.1%和 4.4%比 88.4%）。女性性别和 ALT 水平，但不是免疫抑制或抗病毒药物，是 AHE 患者存在 AIH 相关自身抗体的独立预测因素。52 例 AIH 相关自身抗体阳性的患者进行了 12 个月的随访。在此期间，33 例转为阴性，19 例仍为阳性，但滴度明显降低。总之，AHE 患者 AIH 相关自身抗体的血清流行率升高，尤其是女性，但它们的亚特异性和滴度与 1 型 AIH 不同。急性 HEV 感染可能与 AIH 有关。
