Hepatitic C virus infection and autoimmunity : clinical features, diagnostic tools and therapeutical aspects

Abstract

Summary Since the genom of the hepatitis C virus (HCV) was detected the pathogenesis of a distinct group of chronic liver disease and some non-hepatic disorders of sofar unknown origin could be newly established. A wide variety of clinical features including vasculitis, glomerulonephritis, porphyria and rheumatoid-like symptoms may become apparant separately or in combination. HCV can be precipitated in cryoglobulins and tissue-related HCV was found in liver and kidney specimen, for instance. HCV-related cryoglobulinemia or circulating immune complexes often occur with vasculitis. Hematological changes may be present such as thrombocytopenia. A considerable amount of patients show circulating autoantibodies like anti-LKM antibodies or like anti-GOR antibodies which apparently are closely linked to active hepatitis C. The clinical course of patients with non-hepatic manifestation of HCV infection shows a great variation and is not predictable. Both, immunosuppression as well as interferon-alpha administration were reported to be efficacious. However, hazards of those regimens were also demonstrated. It is now obvious that an hepatitis C virus infection may often lead to distinct immunological disturbances including autoimmunity with sofar unknown significance for disease induction and treatment of the patients. Therefore, both basic research as well as clinical studies are urgently needed to elucidate these extrahepatic features of HCV infection.