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Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance

Yee, LJ; Kelleher, P; Goldin, RD; Marshall, S; Thomas, HC; Alberti, A; Chiaramonte, M; Braconier, Jean Henrik LU ; Hall, AJ and Thursz, MR (2004) In Journal of Viral Hepatitis 11(5). p.459-464
Abstract
We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden (n = 225), the UK (n = 207) and Italy (n = 213) were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46-0.94; P = 0.023]. Duration of HCV... (More)
We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden (n = 225), the UK (n = 207) and Italy (n = 213) were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46-0.94; P = 0.023]. Duration of HCV infection, age at infection, current age, route of infection, viral genotype, alcohol consumption, fibrosis stage and inflammatory score were not correlated with ANA+ or ANA pattern. Female gender was correlated with ANA+ and this association persisted in multivariable analyses (OR = 3.0; P = 0.002). Increased plasma cells were observed in the liver biopsies of ANA-positive individuals compared with ANA-negative individuals, while a trend towards decreased lymphoid aggregates was observed [hazard ratio (HR) = 9.0, P = 0.037; HR = 0.291, P = 0.118, respectively]. No correlations were observed between ANA positivity and nonresponse to therapy (OR = 1.4; P = 0.513), although ANA+ was correlated with faster rates of liver fibrosis, this was not statistically significant (OR = 1.8; P = 0.1452). Low titre ANA+ should not be a contraindication for interferon treatment. Our observation of increased plasma cells in ANA+ biopsies might suggest B-cell polyclonal activity with a secondary clinical manifestation of increased serum immunoglobulins. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gender, comorbidities, autoimmunity, chronic infections, liver
in
Journal of Viral Hepatitis
volume
11
issue
5
pages
459 - 464
publisher
Wiley-Blackwell
external identifiers
  • pmid:15357653
  • wos:000223820000011
  • scopus:5044239483
ISSN
1365-2893
DOI
10.1111/j.1365-2893.2004.00530.x
language
English
LU publication?
yes
id
839eb686-1dbb-42c1-b45b-c4b46053a1f9 (old id 267727)
date added to LUP
2007-11-07 08:23:11
date last changed
2017-07-02 03:43:46
@article{839eb686-1dbb-42c1-b45b-c4b46053a1f9,
  abstract     = {We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden (n = 225), the UK (n = 207) and Italy (n = 213) were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46-0.94; P = 0.023]. Duration of HCV infection, age at infection, current age, route of infection, viral genotype, alcohol consumption, fibrosis stage and inflammatory score were not correlated with ANA+ or ANA pattern. Female gender was correlated with ANA+ and this association persisted in multivariable analyses (OR = 3.0; P = 0.002). Increased plasma cells were observed in the liver biopsies of ANA-positive individuals compared with ANA-negative individuals, while a trend towards decreased lymphoid aggregates was observed [hazard ratio (HR) = 9.0, P = 0.037; HR = 0.291, P = 0.118, respectively]. No correlations were observed between ANA positivity and nonresponse to therapy (OR = 1.4; P = 0.513), although ANA+ was correlated with faster rates of liver fibrosis, this was not statistically significant (OR = 1.8; P = 0.1452). Low titre ANA+ should not be a contraindication for interferon treatment. Our observation of increased plasma cells in ANA+ biopsies might suggest B-cell polyclonal activity with a secondary clinical manifestation of increased serum immunoglobulins.},
  author       = {Yee, LJ and Kelleher, P and Goldin, RD and Marshall, S and Thomas, HC and Alberti, A and Chiaramonte, M and Braconier, Jean Henrik and Hall, AJ and Thursz, MR},
  issn         = {1365-2893},
  keyword      = {gender,comorbidities,autoimmunity,chronic infections,liver},
  language     = {eng},
  number       = {5},
  pages        = {459--464},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Viral Hepatitis},
  title        = {Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance},
  url          = {http://dx.doi.org/10.1111/j.1365-2893.2004.00530.x},
  volume       = {11},
  year         = {2004},
}