ORIGINAL ARTICLES

Antinuclear antibody is associated with a more advanced fibrosis and lower RNA levels of hepatitis C virus in patients with chronic hepatitis C

M-Y Hsieh^1,2, C-Y Dai^1,2,3,4, L-P Lee¹, J-F Huang^1,2,3, W-C Tsai^1,4,5, N-J Hou^1,3, Z-Y Lin^1,4, S-C Chen^1,4, L-Y Wang^1,4, W-Y Chang^1,4, W-L Chuang^1,2 and M-L Yu^1,4

¹ Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
² Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
³ Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
⁴ Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
⁵ Division of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Correspondence to:
Ming-Lung Yu, MD, PhD, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tz-you 1st Road, Kaohsiung city, 807 Taiwan; d820195{at}kmu.edu.tw

Aims: Positive serum antinuclear antibody (ANA) is present in a number of patients with chronic hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of ANA in patients with chronic hepatitis C (CHC) and to elucidate its clinical implications in virological and histological characteristics of CHC infection.

Methods: A total of 614 CHC patients were enrolled in this prospective, hospital-based study. The serum levels of aspartate aminotransferase, alanine aminotransferase and ANA, and HCV genotype, HCV RNA level, and histological activity index scores for liver histopathology, were determined.

Results: The prevalence of positive ANA (titre >1:40) was 35.0%. Women had a significantly higher prevalence than men (41.2 vs 31.0%; p = 0.012). Patients positive for ANA were significantly older (mean (SD), 53.7 (10.5) vs 49.7 (11.3) years; p<0.001) and had higher mean (SD) alanine aminotransferase levels (186.9 (178.8) vs 155.50 (113.5) IU/l; p<0.001) and lower mean (SD) HCV RNA levels (5.2 (0.9) vs 5.4 (1.0) log IU/ml; p = 0.048) than those without ANA. Among 447 patients undergoing liver biopsy, those positive for ANA had a significantly higher mean (SD) fibrosis score (2.0 (1.3) vs 1.5 (1.1); p<0.001) and a higher frequency of F3–4 (69/187, 36.9% vs 50/260, 19.2%; p<0.001) than those negative for ANA. Multivariate logistic regression analyses showed that advanced fibrosis, lower HCV RNA levels and age were significant factors related to positive ANA.

Conclusion: ANA is associated with a more advanced liver fibrosis and lower serum HCV RNA level in patients with CHC.

Keywords: antinuclear antibody; chronic hepatitis C; liver fibrosis; HCV RNA; HCV RNA level

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