VIRUS-INDUCED AUTOIMMUNITY IN HEPATITIS-C VIRUS-INFECTIONS - A RARE EVENT

Serial serum samples from 16 Italian patients presenting with acute he patitis C virus (HCV) infections (which progressed to chronic hepatiti s in six) were screened for the non-organ-specific autoantibodies most frequently associated with autoimmune hepatitis (AIH), as well as for antibodies against the hepatic asialoglycoprotein receptor (ASGP-R) a nd against the GOR peptide. One patient had low titres (1:10-1:80) of liver-kidney microsomal (LKM-1) antibodies during the recovery phase a nd three others had transient low titres of anti-smooth muscle (IgM cl ass, 1:10) or anti-ASGP-R (1:150-1:300). Anti-GOR was detected in 43 ( 65%) of 66 sera from 13 of these patients. There was no correlation be tween any of these findings and progression to chronicity. By comparis on, 18 patients with AIH studied concurrently before institution of im munosuppressive therapy all had antinuclear and/or smooth muscle antib odies, or LKM-1, at 1:40-1:640 and anti-ASGP-R at 1:300-1:2,100. None of these 18 had evidence of HCV infection and all were seronegative fo r anti-GOR. The findings indicate that the autoantibodies usually asso ciated with AIH are rare in HCV infections but the virus can very occa sionally induce a transient autoimmune response. Anti-GOR appears to b e an antibody specifically related to HCV infection and is probably no t a marker of induced autoimmunity, and it does not predict progressio n to chronic hepatitis.