AUTOIMMUNITY IN HEPATITIS-C AND HEPATITIS-D VIRUS-INFECTION

A large number of viruses are capable of inducing acute or chronic hep atitis, The syndrome of chronic hepatitis encompasses not only viral b ut also autoimmune liver diseases. The hepatitis C virus, and recently also the hepatitis D virus have been found to be associated with an a rray of autoimmune syndromes, diseases and markers of autoimmunity, Th e relationship of hepatotropic virus infection and the immune system l eading to virus-associated autoimmunity, and its distinction from genu ine autoimmune disease represents a fascinating field of research, Cli nically, the differentiation between autoimmune liver diseases, virus infection and virus-associated autoimmunity is difficult and epidemiol ogical evaluations have not come up with universally applicable and va lid classification criteria, However, both autoimmune liver diseases a nd viral hepatitis can readily be diagnosed and distinguished through precise and molecularly determined immunological testing systems, The overlap of both, virus-associated autoimmunity, is still at the centre of research activities aimed at establishing diagnostic and risk-asse ssment criteria. Studies of molecular autoantigens and autoepitopes ha ve begun to define the differences of the B-cell response in autoimmun e disease and virus-associated autoimmunity. This provides data that m ay contribute to the safe application of therapeutic strategies as dif ferent as immunosuppression and interferon-alpha (IFN-alpha). The pres ent review focuses on the clinical, epidemilogical and molecular aspec ts of these disease entities.