Prevalence of Autoantibodies in Uremic Patients with HCV Infection

臺灣接受血液透析之C型肝炎患者血清中自體免疫抗體之表現

陳鴻運(Hong-Yun Chen) ； 趙有誠(You-Chen Chao) ； 嚴助成(Juh-Cheng Yan) ； 徐榮源(Jueng-Yuan Hsu) ； 陳永煌(Yung-Hwang Chen)

《Journal of Medical Sciences》 20卷1期 (1999/08) Pp. 7-12

摘要

The advent of specific antiviral therapy for chronic hepatitis C has increased the importance of establishing the correct etiology of chronic hepatitis in patients, especially because interferon alfa (IFN-α) has been reported to exacerbate autoimmune hepatitis (AIH), whereas corticosteroids increase viral replication in chronic hepatitis C. In evaluating patients with chronic hepatitis, we have observed apparent chronic hepatitis C who had serologic and clinical evidence of autoimmunity. The aim of this study is to determine the pattern and prevalence of autoantibodies in uremic patients with HCV infection and others with different liver disease. We studied 162 consecutive, unselected adult patients at our center, identified between September 1997 and December 1997, as having hepatitis C antibodies by second-generation EIA. To be included in the group with chronic hepatitis C, patients were required to have (1) chronic elevation of serum transaminases for at least six months; (2) negative hepatitis B surface antigen; (3) no evidence for other causes of chronic hepatitis. Anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA) and rheumatoid factor (RF) were performed using the procedure as mentioned by Cliford et al. The results were as follows , anti-smooth muscle autoantibodies were common in our chronic hepatitis patients, but no significant difference had appeared against normal control group. Anti-nuclear antibodies and rheumatoid factor were more frequent in chronic hepatitis C patients than in chronic hepatitis B patients, but there was no significant difference. The prevalence of positive RF and ANA in uremic HCV and chronic HCV patients were not significantly different. The prevalence of autoimmune markers between the elderly group and younger group was not different, either. In conclusions, We report a high prevalence of RF and ANA in chronic HCV patients compared with normal population. The prevalence of serological autoantibodies in the HCV patients and the uremic HCV patients were of no significant difference.

關鍵字

自體免疫抗體 ； 類風濕性因子 ； 自體抗核抗體 ； 抗平滑肌抗體 ； 自體免疫性肝炎

並列摘要

The advent of specific antiviral therapy for chronic hepatitis C has increased the importance of establishing the correct etiology of chronic hepatitis in patients, especially because interferon alfa (IFN-α) has been reported to exacerbate autoimmune hepatitis (AIH), whereas corticosteroids increase viral replication in chronic hepatitis C. In evaluating patients with chronic hepatitis, we have observed apparent chronic hepatitis C who had serologic and clinical evidence of autoimmunity. The aim of this study is to determine the pattern and prevalence of autoantibodies in uremic patients with HCV infection and others with different liver disease. We studied 162 consecutive, unselected adult patients at our center, identified between September 1997 and December 1997, as having hepatitis C antibodies by second-generation EIA. To be included in the group with chronic hepatitis C, patients were required to have (1) chronic elevation of serum transaminases for at least six months; (2) negative hepatitis B surface antigen; (3) no evidence for other causes of chronic hepatitis. Anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA) and rheumatoid factor (RF) were performed using the procedure as mentioned by Cliford et al. The results were as follows , anti-smooth muscle autoantibodies were common in our chronic hepatitis patients, but no significant difference had appeared against normal control group. Anti-nuclear antibodies and rheumatoid factor were more frequent in chronic hepatitis C patients than in chronic hepatitis B patients, but there was no significant difference. The prevalence of positive RF and ANA in uremic HCV and chronic HCV patients were not significantly different. The prevalence of autoimmune markers between the elderly group and younger group was not different, either. In conclusions, We report a high prevalence of RF and ANA in chronic HCV patients compared with normal population. The prevalence of serological autoantibodies in the HCV patients and the uremic HCV patients were of no significant difference.

並列關鍵字

anti-nuclear antibodies (ANAs) ； anti-smooth muscle antibodies (SMAs) ； autoantibodies ； autoimmune hepatitis (AIH) ； rheumatoid factor (RF)