Effect of ursodeoxycholic acid on autoimmune-associated chronic hepatitis C

Background: Hypergammaglobulinaemia and various auto-antibodies which are c ommonly seen in autoimmune hepatitis are also found in patients with chroni c hepatitis C. We recently reported that ursodeoxycholic acid (UDCA) improv ed liver function tests and immunoserological markers in patients with type I autoimmune hepatitis. The aim of this study was to prospectively evaluat e the efficacy of UDCA on autoimmune-associated chronic hepatitis C. Methods: Immunoglobulin G (IgG), anti-nuclear antibodies (ANA) and anti-smo oth muscle antibodies (ASMA) were determined in 95 patients with chronic he patitis C. All patients were positive for hepatitis C virus RNA. Autoimmune -associated chronic hepatitis C (C-AIH) was defined by elevated serum IgG l evel (greater than or equal to 2.0 g/dL) and high titres of ANA and/or ASMA (greater than or equal to 1 : 160). Nine (9%) of 95 patients were diagnose d as C-AIH. All the C-AIH patients and 30 of the remaining 86 chronic hepat itis C patients without autoimmune features (CHC) were treated with UDCA (6 00 mg/day) for 1 year. Results: Autoimmune-associated chronic hepatitis C patients included one ma n and eight women and their AIH scores, as defined by the International Aut oimmune Hepatitis Group, were significantly higher than the CHC patients. B efore UDCA therapy, there were no significant differences in aspartate amin otransferase (BST), alanine aminotransferase (ALT) and gamma-glutamyl trans peptidase (gamma-GTP) levels between C-AIH and CHC patients. However, after 1 gear UDCA therapy, AST, ALT and gamma-GTP were significantly lower in C- AIH patients (P < 0.05) than in CHC patients. In C-AIH, ANA titres in seven of nine patients and ASMA titres in five of seven patients were reduced af ter 1 year UDCA treatment. Conclusions: These results suggest that UDCA is a useful therapeutic agent for autoimmune-associated chronic hepatitis C. (C) 1999 Blackwell Science A sia Pty Ltd.