Meyer zum Büschenfelde K H, Lohse A W, Gerken G, Treichel U, Löhr H F, Mohr H, Grosse A, Dienes H P
Department of Medicine, Johannes Gutenberg University, Mainz, Germany.
J Hepatol. 1995;22(1 Suppl):93-6.
Viral infections are considered a possible trigger of autoimmune diseases. In autoimmune liver diseases the hepatotropic viruses, especially hepatitis C virus (HCV), have received particular attention as possible etiological agents. The present study was undertaken to investigate the relation between hepatitis virus infections and autoimmune liver diseases. We found a very low incidence of HCV infection in patients with autoimmune liver diseases. Only 5% (n = 7) of patients with AIH types I and III had antibodies against HCV antigens, but only two of these seven were HCV-RNA positive. Similar results were obtained in patients with PBC and PSC. Furthermore, the coexistence of LKM autoantibodies with chronic HC is a rare event and less common than low-titer ANA and SMA in viral liver diseases. In conclusion, a link between hepatitis viruses B or C and AI-liver diseases is very unlikely. Autoantibodies in viral liver diseases appear to be an expression of a generalized immune activation by cytokines, as observed during interferon treatment in viral liver diseases.
病毒感染被认为是自身免疫性疾病的一个可能触发因素。在自身免疫性肝病中，嗜肝病毒，尤其是丙型肝炎病毒（HCV），作为可能的病因受到了特别关注。本研究旨在调查肝炎病毒感染与自身免疫性肝病之间的关系。我们发现自身免疫性肝病患者中HCV感染的发生率非常低。I型和III型自身免疫性肝炎患者中只有5%（n = 7）有抗HCV抗原抗体，但这7例中只有2例HCV-RNA呈阳性。原发性胆汁性胆管炎（PBC）和原发性硬化性胆管炎（PSC）患者也得到了类似结果。此外，LKM自身抗体与慢性HCV共存是罕见事件，且在病毒性肝病中比低滴度抗核抗体（ANA）和抗平滑肌抗体（SMA）少见。总之，乙型或丙型肝炎病毒与自身免疫性肝病之间的联系非常不可能。病毒性肝病中的自身抗体似乎是细胞因子引起的全身性免疫激活的一种表现，如在病毒性肝病的干扰素治疗期间所观察到的那样。
