Author information
1
Department of Medicine, Stanford University, Palo Alto, California, USA.
2
Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, California, USA.
3
Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital, ShangHai, China.
4
Center for Clinical Informatics, Stanford University, Stanford, California, USA.
5
Departments of Medicine and Surgery, Baylor College of Medicine, Houston, Texas, USA.
Abstract
GOALS:
To examine the role that autoantibodies (auto-abs) play in chronic hepatitis C virus (HCV) regarding demographics, presence of extrahepatic manifestations and long-term outcomes in a large US cohort.
BACKGROUND:
Auto-abs have been reported to be prevalent in patients with chronic HCV infection, but data on the natural history of these patients are limited.
STUDY:
The study included 1556 consecutive patients with HCV without concurrent HIV and/or HBV who had testing for antinuclear antibody (ANA), antimitochondrial antibody (AMA), antismooth muscle antibody (ASMA) and/or antiliver kidney microsomal antibody (LKM). Primary outcomes included development of cirrhosis, hepatic decompensations, hepatocellular carcinoma (HCC), mortality and/or sustained virological response (SVR) to antiviral therapy.
RESULTS:
A total of 388 patients tested positive for any auto-ab (ANA 21.8%, ASMA 13.3%, AMA 2.2% and LKM 1.2%). Patients who tested positive versus negative were more likely to be women (29.3% vs 20.9%, p<0.001) and less likely to achieve SVR with most treated patients receiving interferon-based therapies (37.2% vs 47.1%, p=0.031). There was no difference between groups for baseline laboratory data, disease state or rate of extrahepatic manifestations (42.8% vs 45.0%, p=0.44). Kaplan-Meier analysis revealed no statistically significant difference between groups for the 10-year development of cirrhosis, hepatic decompensations, HCC nor survival. Furthermore, auto-ab positivity was only found to be a predictor for a lower rate of SVR on multivariate analysis (adjusted OR=1.61, 95 % CI 1.00 to 2.58, p=0.048).
CONCLUSIONS:
In our cohort, auto-ab positivity was common, especially in women, and predicted a lower rate of SVR but otherwise had no impact on the natural history of chronic HCV or presence of extrahepatic manifestations.