ANTIMITOCHONDRIAL ANTIBODIES IN PATIENTS WITH CHRONIC HEPATITIS-C

Although autoantibodies have been found in the serum of patients with chronic hepatitis C virus (HCV) there has been no convincing evidence of the presence of antimitochondrial antibodies, until now. Sera from 460 untreated patients with chronic hepatitis C were tested for antimi tochondrial antibodies, using an indirect immunofluorescence technique ; and if they tested positive for the antibodies (titer more than 1:50 ), they also were treated by Western blot analysis. Seven (1.5%) sera were positive, None of the patients had biological or histological evi dence of primary biliary cirrhosis. Antimitochondrial antibodies recog nized one of the oxo-dehydrogenase multienzyme complexe's epitopes by Western blot assay in three patients only, All seven patients were the n treated by interferon alpha for six months. None showed exacerbation of liver disease during treatment. HCV-RNA disappeared from the serum in one patient who became negative for anti-M2 antibodies. The four p atients who did not respond to interferon-alpha therapy, and the two w ho relapsed after treatment withdrawal, had sustained positive antimit ochondrial antibodies. These data suggest that: 1) antimitochondrial a ntibodies present in patients with chronic hepatitis C do not always r ecognize the same epitopes as in primary biliary cirrhosis; 2) these a ntibodies may disappear after eradication of HCV, suggesting that the production of antimitochondrial antibodies is linked to the presence o f the virus and 3) the clinical and biological course of chronic hepat itis C, and the response to interferon-alpha therapy, does not seem to be different in patients who are positive for antimitochondrial antib odies.