Pivetti S, Novarino A, Merico F, Bertero M T, Brunetto M R, Bonino F, Caligaris-Cappio F
Dipartimento di Scienze Biomediche e Oncologia Umana, Università di Torino, Italy.
Br J Haematol. 1996 Oct;95(1):204-11. doi: 10.1046/j.1365-2141.1996.7542376.x.
The aim of this study was to investigate whether hepatitis C virus (HCV) may perturb the immune system towards autoreactivity. We studied the relationship between the prevalence of anti-HCV and the presence of laboratory and/or clinical autoimmune features in 300 patients: lymphoid malignancies (167) and autoimmune disorders (connective tissue diseases 100; idiopathic thrombocytopenic purpura (ITP) 33). As a control, hepatitis B surface antigen (HBV) and anti-hepatitis B core antigen (anti-HBc) were related to the same parameters. Anti-HCV and anti-HBV were detected in 68/300 (22.6%) and 70/300 (24.6%) patients, respectively. HCV prevalence was 18% in lymphoproliferative disorders (anti-HBc 28.1%) and 26% in connective tissue disease (anti-HBc 16.3%). Among ITP cases, 12/33 (36.4%) were anti-HCV+ and 10/33 (30.3%) anti-HBc+. In 24/30 (80%) anti-HCV+ patients with lymphoproliferative disorders at least one serologic or clinical autoimmune abnormality was detected. To the contrary, only 10/45 (22.2%) anti-HBc+ patients with lymphoproliferative disorders had at least one serologic or clinical abnormality (P < 0.0001). A statistically significant correlation was observed between HCV prevalence and the number of autoimmune alterations in both lymphoproliferative and connective tissue disorders, which was not found for anti-HBc. These data suggest that HCV may skew the immune system toward the production of autoantibodies and also support the possibility that some cases of ITP may be linked to both HCV and HBV infection.
本研究的目的是调查丙型肝炎病毒（HCV）是否会使免疫系统偏向自身反应性。我们研究了300例患者中抗HCV的流行率与实验室和/或临床自身免疫特征之间的关系：淋巴系统恶性肿瘤（167例）和自身免疫性疾病（结缔组织病100例；特发性血小板减少性紫癜（ITP）33例）。作为对照，将乙型肝炎表面抗原（HBV）和抗乙型肝炎核心抗原（抗HBc）与相同参数相关联。分别在68/300（22.6%）和70/300（24.6%）例患者中检测到抗HCV和抗HBV。HCV在淋巴增生性疾病中的流行率为18%（抗HBc为28.1%），在结缔组织病中的流行率为26%（抗HBc为16.3%）。在ITP病例中，12/33（36.4%）为抗HCV阳性，10/33（30.3%）为抗HBc阳性。在24/30（80%）抗HCV阳性的淋巴增生性疾病患者中，检测到至少一种血清学或临床自身免疫异常。相反，在45例抗HBc阳性的淋巴增生性疾病患者中，只有10/45（22.2%）有至少一种血清学或临床异常（P<0.0001）。在淋巴增生性疾病和结缔组织病中，均观察到HCV流行率与自身免疫改变数量之间存在统计学显著相关性，而抗HBc未发现这种相关性。这些数据表明，HCV可能使免疫系统偏向产生自身抗体，也支持了一些ITP病例可能与HCV和HBV感染均有关的可能性。
