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Antinuclear antibody is associated with a more advanced fibrosis and lower RNA levels of hepatitis C virus in patients with chronic hepatitis C
  1. M-Y Hsieh1,2,
  2. C-Y Dai1,2,3,4,
  3. L-P Lee1,
  4. J-F Huang1,2,3,
  5. W-C Tsai1,4,5,
  6. N-J Hou1,3,
  7. Z-Y Lin1,4,
  8. S-C Chen1,4,
  9. L-Y Wang1,4,
  10. W-Y Chang1,4,
  11. W-L Chuang1,2,
  12. M-L Yu1,4
  1. 1
    Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  2. 2
    Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  3. 3
    Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
  4. 4
    Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  5. 5
    Division of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  1. Ming-Lung Yu, MD, PhD, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tz-you 1st Road, Kaohsiung city, 807 Taiwan; d820195{at}kmu.edu.tw

Abstract

Aims: Positive serum antinuclear antibody (ANA) is present in a number of patients with chronic hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of ANA in patients with chronic hepatitis C (CHC) and to elucidate its clinical implications in virological and histological characteristics of CHC infection.

Methods: A total of 614 CHC patients were enrolled in this prospective, hospital-based study. The serum levels of aspartate aminotransferase, alanine aminotransferase and ANA, and HCV genotype, HCV RNA level, and histological activity index scores for liver histopathology, were determined.

Results: The prevalence of positive ANA (titre >1:40) was 35.0%. Women had a significantly higher prevalence than men (41.2 vs 31.0%; p = 0.012). Patients positive for ANA were significantly older (mean (SD), 53.7 (10.5) vs 49.7 (11.3) years; p<0.001) and had higher mean (SD) alanine aminotransferase levels (186.9 (178.8) vs 155.50 (113.5) IU/l; p<0.001) and lower mean (SD) HCV RNA levels (5.2 (0.9) vs 5.4 (1.0) log IU/ml; p = 0.048) than those without ANA. Among 447 patients undergoing liver biopsy, those positive for ANA had a significantly higher mean (SD) fibrosis score (2.0 (1.3) vs 1.5 (1.1); p<0.001) and a higher frequency of F3–4 (69/187, 36.9% vs 50/260, 19.2%; p<0.001) than those negative for ANA. Multivariate logistic regression analyses showed that advanced fibrosis, lower HCV RNA levels and age were significant factors related to positive ANA.

Conclusion: ANA is associated with a more advanced liver fibrosis and lower serum HCV RNA level in patients with CHC.

  • antinuclear antibody
  • chronic hepatitis C
  • liver fibrosis
  • HCV RNA
  • HCV RNA level

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Footnotes

  • Competing interests: None.