Abstract
Background and study aim : The prevalence of antinuclear antibody (ANA) has been documented in patients with hepatitis C virus (HCV) infection. Hepatitis C virus infection plays an important role in the pathogenesis of immunological derangement, but the mechanism remains unclear. The aim of this study is to detect the significance of ANA positivity and its impact on histopathology and early virological response (EVR) to combined antiviral therapy in chronic HCV patients. . Patients and Methods:Two hundred Egyptian chronic HCV naive patients were enrolled in this study. Antinuclear antibody (ANA) was detected by ELISA and it was considered positive with a titer > 1 : 14 by indirect immunofluorescence. Complete laboratory investigations and histological examination were done as a pretreatment work up for all patients. Patients were followed up during treatment and EVR was assessed in ANA positive and negative patients. Results: There was a statistically significant difference between ANA positive and negative patients regarding viral load and histopathological criteria and no significant difference was detected regarding other demographic and laboratory criteria. EVR was close in ANA positive and ANA negative patients (77 for the former Vs. 80 for the later with P = 0.33). No autoimmune manifestations were detected during treatment among positive cases. Except for ALT & AST levels no statistically significant differences were detected between ANA positive and negative cases regarding haematological data, thyroid dysfunction. BMI, ALT levels, viral load and fibrosis stages were independent predictors of EVR. Conclusion: ANA postivity in chronic HCV patients was associated with advanced fibrosis but didn't affect treatment response.
Highlights
Hepatitis C virus (HCV) infection is the most common cause of chronic liver disease in the world [1]
The objective of this study was to detect the significance of antinuclear antibodies (ANA) positivity in chronic HCV patients regarding the effect of its presence on histopathology and early virological response (EVR) to pegylated interferon and ribavirin
Patients characteristics and factors associated with ANA postivity: This study was conducted on 200 patients with HCV infection (69.5% of them were males) who classiffied into 2 groups: 100 ANA positive and 100 ANA negative patients
Summary
Hepatitis C virus (HCV) infection is the most common cause of chronic liver disease in the world [1]. It is estimated that 130-170 million people were chronically infected with HCV at the end of 20th century, and 2.4-4.7 million new infections per year [2]. Several immunologic abnormalities, such as production of auto antibodies, rheumatoid factor, and cryglobulin, has been associated with HCV infection. The mechanism of production of these antibodies in HCV infection remains obscure. The prevalence of antinuclear antibody (ANA) has been documented in patients with hepatitis C virus (HCV) infection. Hepatitis C virus infection plays an important role in the pathogenesis of immunological derangement, but the mechanism remains unclear. The aim of this study is to detect the significance of ANA positivity and its impact on histopathology and early virological response (EVR) to combined antiviral therapy in chronic HCV patients
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