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

Abstract

Aims: Positive serum antinuclear antibody (ANA) emerges in some proportion of patients with chronic hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of ANA in chronic hepatitis C (CHC) patients and to elucidate its clinical implication in the virologic and histologic characteristics.

Methods: Total 614 CHC patients were enrolled in this prospective, hospital-based study. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ANA, HCV genotypes, HCV RNA levels and histologic activity index (HAI) scores for liver histopathology were determined.

Results: The prevalence of positive ANA (titer > 1:40) was 35.0%. Women had a significantly higher prevalence than men (41.2% vs. 31.0%, P = 0.012). Patients with positive ANA were significantly older (mean 53.7 ± 10.5 vs. 49.7 ¡&Oacute 11.3 yrs, P < 0.001) and had higher mean ALT levels (186.9 ± 178.8 vs. 155.50 ± 113.5 IU/L, P < 0.001) and lower mean HCV RNA levels (5.2 ± 0.9 vs. 5.4 ± 1.0 log IU/mL, P = 0.048) than those without. Amongst 447 patients receiving liver biopsy, those with positive ANA significantly had a higher mean 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 without. 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 levels in CHC patients.