Autoantibody positivity in chronic hepatitis C pre- and post-direct-acting antiviral therapy: a prospective multicenter south Korean study.

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Translational gastroenterology and hepatology Pub Date : 2025-04-10 eCollection Date: 2025-01-01 DOI:10.21037/tgh-24-134
Su Hyun Choi, Gwang Hyeon Choi, Eun Sun Jang, Youn Jae Lee, Young Seok Kim, In Hee Kim, Sung Bum Cho, Byung Seok Lee, Kyung-Ah Kim, Woo Jin Chung, Dahye Baik, Moran Ki, Sook-Hyang Jeong
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Abstract

Background: Hepatitis C virus (HCV) infection causes extrahepatic manifestations involving B-cell dysregulation and autoantibody production. This study aimed to elucidate the positivity rates of four autoantibodies [anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), anti-liver kidney microsomal type 1 (anti-LKM1), and anti-mitochondrial antibody (AMA)] in patients with chronic hepatitis C (CHC) before and after direct-acting antiviral (DAA) therapy compared to those in healthy controls.

Methods: This study enrolled prospectively collected plasma samples from 201 CHC patients [median age, 62 years; 49.8% women; 100% sustained virological response (SVR)] from eight hospitals before and after DAA therapy and 127 healthy individuals. Autoantibodies were detected using indirect immunofluorescence.

Results: The positivity rate of ANA was higher in CHC patients than in healthy controls (32.3% vs. 21.3%, P=0.03) at pretreatment (PreTx) and decreased at SVR (32.3% vs. 23.9%, P=0.009). Female sex and higher globulin levels were related to ANA positivity in the control and CHC patient groups. Thirty-seven (57%) of 65 patients with ANA-positive HCV at PreTx maintained ANA-positivity at SVR. Among the 136 ANA-negative patients at PreTx, 11 (8%) showed newly positive ANA conversion at SVR. Patients with ANA positivity at SVR (n=48) were older and had a higher proportion of advanced liver disease than ANA-negative patients (n=153).

Conclusions: ANA positivity was observed in one-third of CHC patients at PreTx, which was significantly higher than that in healthy controls and decreased after SVR. CHC patients with ANA positivity after SVR were older and had more advanced liver disease than those with ANA negativity, suggesting persistent immune dysregulation after cure.

慢性丙型肝炎直接抗病毒治疗前后自身抗体阳性:韩国一项前瞻性多中心研究
背景:丙型肝炎病毒(HCV)感染引起肝外表现,包括b细胞失调和自身抗体的产生。本研究旨在阐明慢性丙型肝炎(CHC)患者在直接作用抗病毒药物(DAA)治疗前后的四种自身抗体(抗核抗体(ANA)、抗平滑肌抗体(ASMA)、抗肝肾微粒体1型抗体(anti-LKM1)和抗线粒体抗体(AMA))与健康对照的阳性率。方法:本研究前瞻性地收集了201例CHC患者的血浆样本[中位年龄62岁;49.8%的女性;8家医院和127名健康个体在DAA治疗前后的100%持续病毒学反应(SVR)。采用间接免疫荧光法检测自身抗体。结果:CHC患者在预处理(prex)时ANA阳性率高于健康对照组(32.3%比21.3%,P=0.03),在SVR时ANA阳性率低于健康对照组(32.3%比23.9%,P=0.009)。在对照组和CHC患者组,女性和较高的球蛋白水平与ANA阳性有关。在prex时,65例ana阳性HCV患者中有37例(57%)在SVR时保持ana阳性。在prex的136例ANA阴性患者中,11例(8%)在SVR时出现新阳性ANA转化。在SVR中ANA阳性的患者(n=48)比ANA阴性的患者(n=153)年龄更大,晚期肝病的比例更高。结论:三分之一的CHC患者在prex检测到ANA阳性,明显高于健康对照组,SVR后呈下降趋势。与ANA阴性的CHC患者相比,SVR后ANA阳性的CHC患者年龄更大,肝病进展更严重,提示治愈后持续免疫失调。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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