CLINICAL-SIGNIFICANCE OF SERUM AUTOANTIBODIES IN CHINESE PATIENTS WITH CHRONIC HEPATITIS-C - NEGATIVE ROLE OF SERUM VIRAL TITER AND GENOTYPE

Positive serum anti-nuclear antibody (ANA) and anti-smooth muscle anti body (SMA) have been reported in 10-66% of patients with chronic hepat itis C virus (HCV) infection from Western countries. However, the mech anism involved in this immunological disorder is still unknown. This s tudy was carried out to evaluate the prevalence and clinical significa nce of positive serum auto-antibodies in Chinese patients with chronic hepatitis C and to assess the role of serum HCV-RNA titre and HCV gen otype in the presence of serum auto-antibodies. Serum ANA, SMA and ant i-mitochondrial antibody (AMA) were measured in 122 patients with chro nic hepatitis C. Clinical, biochemical and virological data (serum HCV -RNA titre and HCV genotype) were compared between patients with and w ithout serum auto-antibodies. Fifty-eight (48%) patients were associat ed with positive serum autoantibodies: 42 (34%) positive for ANA, six (5%) positive for SMA, nine (7%) positive for both ANA and SMA and one (1%) positive for AMA. Clinical parameters (age, sex, blood transfusi on history), liver biochemical tests, the presence of cryoglobulinaemi a or cirrhosis, and the response to interferon treatment were not sign ificantly different between patients with and without positive serum a utoantibodies. Serum HCV-RNA levels and HCV genotypes were also not si gnificantly different between the two groups. Logistic regression anal ysis showed that none of the previously mentioned parameters were sign ificant predictors to associate with serum auto-antibodies in chronic hepatitis C. We concluded that 48% of Chinese patients with chronic he patitis C were associated with positive serum autoantibodies. Hepatiti s C virus genotypes and serum HCV-RNA levels were not correlated to th e presence of serum auto-antibodies. The clinical significance and act ual pathogenesis of this phenomenon remain to be clarified.