DETECTION OF HCV-RNA IN PARAFFIN-EMBEDDED LIVER BIOPSIES FROM PATIENTS WITH AUTOIMMUNE HEPATITIS

Background/Aims: There may be a relationship between autoimmune hepati tis and viral infection, To examine this relationship, 19 patients wit h autoimmune hepatitis and/or chronic hepatitis C were studied. Method s: Patients were selected initially on the basis of having autoantibod ies (anti-nuclear, anti-smooth muscle, or anti-liver-kidney microsomal ) in serum. Formalin-fixed, paraffin-embedded liver biopsies from thes e patients were tested for HCV-RNA by polymerase chain reaction, The b iopsies were examined histologically to detect features suggestive of chronic hepatitis C or autoimmune hepatitis, The results were correlat ed with serum anti-HCV and HCV-RNA, and with response to steroid thera py. Results: Five of the nineteen patients had detectable HCV-RNA in t heir liver biopsies, In two of three patients from whom serum was avai lable, HCV-RNA was detectable, The remaining 14 patients were negative for HCV-RNA by tissue polymerase chain reaction, Serum was available from 11 of these patients, and serum HCV-RNA was negative in all, All of the three HCV-RNA-positive patients who were treated with steroids showed a partial response; tissue positivity for HCV-RNA was significa ntly higher in partial responders than in complete responders (60% vs 0%, p=0.01), Severe portal and periportal inflammation with prominent plasma cells together with bridging parenchymal necrosis were seen mor e often in HCV-negative biopsies, Mild portal and periportal inflammat ion with portal lymphoid aggregates, apoptosis and spotty parenchymal necrosis were seen more in HCV-positive biopsies. Conclusions: These r esults show that hepatitis C virus can be detected in some patients wi th circulating autoantibodies, The ability to detect HCV-RNA in paraff in-embedded archival material provides a valuable addition to the batt ery of available HCV tests.