To evaluate the pattern, prevalence and clinical importance of an array of autoantibodies in chronic HCV infection, 117 cases were studied [70 with chronic HCV, 27 with chronic hepatitis B virus (HBV) infection, and 20 normal control]. Clinical evaluation, testing for schistosomiasis, liver functions, and testing for anti-HCV antibody (Ab)by second generation ELISA and for HBsAg were performed. The antinuclear (ANA), antismooth muscle (ASMA), antimitochondrial (AMA), anti-liver-kidney microsome type 1 (LKM1 Ab), antithyroglobulin (ATG) and antithyroid microsomal (ATM) antibodies were screened by indirect immunofluorescence. Autoantibodies were positive if the titer is > 1/20. One or more autoantibodies was found in 78.6% of HCV cases (versus 18.5% in chronic HBV and 5% in normals. The prevalence of autoantibodies in the HCV group were : 68.6% for ANA, 55.7% for ASMA, 52.6% for antiLICMI, 2.9% for each of AMA and ATG and 1.4% for ATM. These results of serum ANA, ASMA and anti-LKM1 Ab were significantly higher than those in the other 2 groups (Pc 0.001). Unlike autoimmune liver disease, the prevalence of autoimmune markers in chronic HCV cases was not sex-related and were independent of the presence of cirrhosis or active schistosomiasis. In conclusions extrahepatic autoimmune disorders are widely prevalent in Egyptian chronic • HCV patients. Strikingly high prevalence of anti-LKM1 Ab was noticed in our HCV cases which might be serotype - associated. Immunological disorders were not sex-related and were unlikely to be affected by the presence of cirrhosis or active schistosomiasis. Our findings may indicate the co-existence of autoimmune hepatitis and chronic HCV in our locality |
