Işıl FİDAN, Seyyal ROTA, Resul KARAKUŞ, Hülya DURAN, Melek ERTAŞ, Zübeyde LALE, Turgut İMİR

Kronik hepatit C hastalarında otoantikor sıklığı ve HCV RNA pozitifliği ile ilişkisi

Kronik hepatit C infeksiyonlu hastaların serum örneklerinde otoantikor pozitifliği sıklığı ve otoantikor varlığı ile HCV RNA pozitifliği arasındaki ilişki incelenmiştir. Bu amaçla 121 anti-HCV pozitif ve 68 anti-HCV negatif serum örneği çalışma kapsamına alınmıştır. Serum ANA, AMA, ASMA, LKM otoantikorlarına indirek immünofloresan yöntemi ile bakılmıştır. HCV RNA, kantitatif real-time polimeraz zincir reaksiyonu ile belirlenmiştir. Anti-HCV pozitif ve anti-HCV negatif örnekler arasında otoantikorlardan en az birinin pozitifliği açısından anlamlı bir fark bulunmamıştır. ANA sıklığı, anti-HCV negatif örneklerde anti-HCV pozitif örneklere göre daha yüksek tespit edilmiş tir. HCV RNA pozitif örneklerde AMA insidansı daha yüksek olarak bulunmuştur. HCV RNA pozitif olan otoantikor pozitif örneklerde viral yük daha düşük olarak belirlenmiştir. Sonuç olarak, kronik hepatit C infeksiyonu bulunan hastalarda otoantikorlar sıklıkla bulunmasına rağmen, otoantikor üretimi ve HCV infeksiyonu arasındaki ilişki hâlâ tartışmalıdır. Kronik hepatit C infeksiyonunda otoimmün mekanizmaların anlaşılabilmesi için daha geniş kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Hepatit C, RNA, Hepatit C antikorları, Hepatit C, kronik

The prevalence of autoantibodies in patients with chronic hepatitis C and the relationship between autoantibodies and HCV RNA positivity

The prevalence of autoantibodies positivity in serum samples of patients with chronic hepatitis C infection, and the relationship between the presence of autoantibodies and HCV RNA positivity were investigated. Serum samples of 121 anti- HCV positive and 68 anti-HCV negative patients were included in this study. Serum ANA, ASMA, AMA, LKM were detected by indirect immunofluorescence assay. HCV RNAs were detected by using quantitative real-time polymerase chain reaction. There was no significant differences in positivite for at least one autoantibodies between anti-HCV positive and anti HCV negative samples. The positivity of ANA was found to be higher among anti-HCV negative samples compared to the anti-HCV positive samples. A significantly higher incidence of AMA were seen in HCV RNA positive samples. The HCV viral load was significantly lower in the autoantibody positive samples with HCV RNA positive. In conclusion, although autoantibodies are commonly found among patients with chronic hepatitis C infection, the relationship between autoantibodies production and HCV infection is still controversial. More studies are required to unders- tand the autoimmune mechanisms in chronic hepatitis C infection.

Keywords:

Hepatitis C, RNA, Hepatitis C Antibodies, Hepatitis C, Chronic,

PDF

___

1. Andrade LJ, Melo PR, Atta AM et al. Smooth muscle antibodies and cryoglobulinemia are asso ciated with advanced liver fibrosis in Brazilian hepatitis C virus carriers, Braz J Infect Dis 2011;15(1):66-8. PMid:21412592
2. Bai L, Feng Z, Lu H, Li W, Yu M, Xu XY. Prevalence of antinuclear and anti-liver-kidney-microsome type-1 antibodies in patients with chronic hepati tis C in China, Chin Med J 2009;122(1):5-9.
3. Bianchi FB, Muratori P, Granito A, Pappas G, Ferri S, Muratori L. Hepatitis C and autoreactivity, Dig Liver Dis 2007;39(Suppl 1):S22-4. http://dx.doi.org/10.1016/S1590-8658(07)80006-5
4. Bogdanos DP, Invernizzi P, Mackay IR, Vergani D. Autoimmune liver serology: current diagnostic and clinical challenges, World J Gastroenterol 2008;14(21):3374-87. http://dx.doi.org/10.3748/wjg.14.3374 PMid:18528935 PMCid:2716592
5. Chrétien P, Chousterman M, Abd Alsamad I et al. Non-organ-specific autoantibodies in chronic hepatitis C patients: association with histological activity and fibrosis, J Autoimmun 2009;32(3-4):201-5. http://dx.doi.org/10.1016/j.jaut.2009.02.005 PMid:19324518
6. Hsieh MY, Dai CY, Lee LP et al. Antinuclear anti body is associated with a more advanced fibrosis and lower RNA levels of hepatitis C virus in pati ents with chronic hepatitis C, J Clin Pathol 2008;61(3):333-7. http://dx.doi.org/10.1136/jcp.2006.046276 PMid:17545561
7. Narciso-Schiavon JL, Freire FC, Suarez MM et al. Antinuclear antibody positivity in patients with chronic hepatitis C: clinically relevant or an epip henomenon? Eur J Gastroenterol Hepatol 2009;21(4):350-6. http://dx.doi.org/10.1097/MEG.0b013e3283089392
8. Ramos-Casals M, Pares A, Jara LJ et al. Antimitochondrial antibodies in patients with chronic hepatitis C virus infection: description of 18 cases and review of the literature, J Viral Hepat 2005;12(6):648-54. http://dx.doi.org/10.1111/j.1365-2893.2005.00642.x PMid:16255767
9. Rigopoulou EI, Mytilinaiou M, Romanidou O, Liaskos C, Dalekos GN. Autoimmune hepatitis specific antibodies against soluble liver antigen and liver cytosol type 1 in patients with chronic viral hepatitis, J Autoimmune Dis 2007;4:2. http://dx.doi.org/10.1186/1740-2557-4-2 PMid:17274827 PMCid:1796878
10. Seçkin Y, Karıncaoğlu M, Cömert M et al. Kronik hepatit B ve C hastalarında otoantikor görülme sıklığı, Cumhuriyet Tıp Derg 2009;31(4):388-92.
11. Shantha S, Thyagarajan SP, Premavathy RK et al. Correlation of autoimmune reactivity with hepati tis B and C virus (HBV and HCV) infection in histologically proven chronic liver diseases, Indian J Med Microbiol 2002;20(1):12-5. PMid:17657016
12. Strassburg CP, Vogel A, Manns MP. Autoimmunity and hepatitis C, Autoimmun Rev 2003;2(6):322-31. http://dx.doi.org/10.1016/S1568-9972(03)00036-3
13. Wasmuth HE, Stolte C, Geier A et al. The presence of non-organ-specific autoantibodies is associated with a negative response to combination therapy with interferon and ribavirin for chronic hepatitis C, BMC Infect Dis 2004;4:4. http://dx.doi.org/10.1186/1471-2334-4-4 PMid:15040810 PMCid:373450
14. Williams MJ, Lawson A, Neal KR, Ryder SD, Irving WL. Autoantibodies in chronic hepatitis C virus infection and their association with disease profile, J Viral Hepat 2009;16(5):325-31. http://dx.doi.org/10.1111/j.1365-2893.2008.01035.x PMid:19302340
15. Yee LJ, Kelleher P, Goldin RD et al. Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical rele vance, J Viral Hepat 2004;11(5):459-64. http://dx.doi.org/10.1111/j.1365-2893.2004.00530.x PMid:15357653
16. Yumuk Z, Sayan M, Çalışkan Ş. Kronik hepatit C hastalarında oto-antikorların HCV RNA düzeyi ile ilişkisi, İnfeksiyon Derg 2008;22(1):29-34.
17. Zusinaite E, Metskula K, Salupere R. Autoantibodies and hepatitis C virus genotypes in chronic hepati tis C patients in Estonia, World J Gastroenterol 2005;11(4):488-91. PMid:15641131