THE INTERNATIONAL AUTOIMMUNE HEPATITIS SCORE IN CHRONIC HEPATITIS-C

Clinical and laboratory findings of autoimmunity are common in chronic hepatitis C. Autoimmune hepatitis (AIH), a disease of unknown cause, has been defined by use of the International Autoimmune Hepatitis Grou p Score (AIH score), which quantifies clinical and laboratory paramete rs. To further validate the specificity of the International AIH score and investigate the similarities between hepatitis C and AIH, we meas ured the International Autoimmune Hepatitis Group Score in patients wi th well-defined chronic hepatitis C. Thirty consecutive non-cirrhotic patients with chronic hepatitis C were evaluated, Scoring was performe d using both components of the AM score: a set of minimum required par ameters including laboratory and historical data and a second set of a dditional parameters dominated by histological criteria, Autoantibodie s were positive in 21 of 30 hepatitis C patients and associated (patie nt or first-degree relative) autoimmune diseases were present in eight of 30 patients, Histologically, chronic active hepatitis with peripor tal piecemeal necrosis was seen in 24 of 30 patients and lymphoid foll icles in 16 of 30 patients, No patient scored as probable or definite AIH using the minimum required parameters of the AM score. When histol ogical parameters were included, four of 30 patients scored as probabl e AIH but none as definite AIH. Therefore, AIH was excluded by the min imal and additional criteria of the AIH score in 86% of patients with hepatitis C despite a high prevalence of autoantibodies in these patie nts, We conclude that the criteria set forth by the International AIH scoring system defines a distinct disease although it shares some feat ures with chronic hepatitis C, Modification of the AIH scoring system to include other commonly accepted risk factors for hepatitis C and ad ditional histological parameters would further improve its specificity .