Prevalence and clinical significance of antiphospholipid antibodies in chronic hepatitis C

BACKGROUND: To know the prevalence of antiphospholipid antibodies in chroni c hepatitis C and their relationship with disease progression. METHODS: One hundred and twenty-eight patients with chronic hepatitis C and 93 healthy controls were enrolled up. We determined platelets, ALT, gamma GT, RNAHCV in serum and liver and non-organ specific antibodies, grade and stage in liver biopsy, risk factors, duration of disease and alcohol intake were also included. Portal hypertension and liver function parameters were studied. Antiphospholipid antibodies (APA): lupus anticoagulant (LA) and a nticardiolipin antibodies (ACA) (IgG and IgM) were measured by EIA. Anti-be ta 2 glycoprotein I antibodies were also detected by EIA in ACA positive pa tients. RESULTS: Thirty one out of 128 (25%; 95%CI: 17.8%-33.4%) showed positive an tiphospholipid antibodies. Positive ACA-IgG was higher in patients than con trols (22% vs 3.2%; p < 0.05), whereas, ACA-IgM was similar (5% vs 3.2%; p = NS), and LA was absent in both groups. ALT levels, viraemia, viral load i n liver, platelets, or ANA titre were similar in patients with and without positive ACA-IgG. Risk factors, duration of disease or alcohol intake were not related yet. Patients with staging F1 showed positive ACA-IgG 4 of 44 ( 9%; 95%CI: 2.5%-21.7%), in staging F2 7 of 39 (18%; 95%CI: 7.5%-33.5%) and in staging F4 17 of 45 (38%; 95%CI: 23.8%-53.5%; p < 0.005). ACA-IgG was si gnificantly related to portal hypertension, Child-Pugh stage and presence o f cirrhosis complications. Anti-beta 2 glycoprotein I antibodies were detec ted in ten (43.5%.; CI95%: 23.2%-65.5%) out of 23 ACA positive patients. CONCLUSIONS: ACA-IgG seems to be associated with chronic hepatitis C, and c ould play a potential role in fibrosis progression and liver disease in the se patients.