AUTOANTIBODIES, MIXED CRYOGLOBULINEMIAS AND HISTOLOGIC LESIONS OF CHRONIC VIRAL-HEPATITIS-C

The purpose of this prospective work was to study a possible relations hip between autoantibodies, cryoglobulinaemia and liver histologic les ions in chronic hepatitis C. Ninety three patients (mean age : 43.3 ye ars) with histologically proven chronic hepatitis were studied. Chroni c hepatitis was associated with cirrhosis in 18 cases. Autoantibodies detection was performed in the serum of all patients and cryoglobulina emia detection was performed in 47 patients. The prevalence of auto-an tibodies was also studied in 45 blood donors (control group) and 30 pa tients with chronic hepatitis B. Histologic study included Knodell sco re and semi-quantitatively expressed histologic lesions considered as more specific of chronic hepatitis C. Twenty six of the 93 patients (2 8 %) had at least an autoantibody with a level greater than or equal t o 1/100. The autoantibodies prevalence was : smooth muscle : 15 %, ant inuclear : 15 %, LKM 1 : 1.2 %, mitochondrial : 0. A mixed cryoglobuli naemia was present in 23 of 47 patients (49 %). The prevalence of anti -smooth-muscle autoantibodies was significantly increased in hepatitis C patients compared with the control group (P < 0.05). The histologic Knodell score was 7.3 +/- 3.6. The histologic lesion prevalence was: portal tract lymphoid follicles: 97 %, acidophil bodies: 85 %, intra-s inusoidal lymphoid infiltrates: 71 %, steatosis: 61 %, microgranulomas : 54 %, biliary duct tract damages: 53 %. No statistical significant c orrelation was found between autoantibodies prevalence and liver histo logic lesions. The Knodell score was only significantly increased in p atients with mixed cryoglobulinaemia (8.4 +/- 3.6 vs 6.2 +/- 2.8) (P < 0.05). These results suggest that the autoantibodies presence in chro nic hepatitis C does not change hepatic histologic lesions. The presen ce of cryoglobulinaemia might signify a more active disease without in duction of specific histological lesions.