High prevalence of autoantibodies in Hepatitis A infection : The impact on laboratory profiles

Abstract

Aims: In the absence of IgM antibodies against HAV, HAV infections can be regarded as autoimmune hepatitis when they show positive autoantibodies by indirect immunofluorescence and lack other viral markers. In this study, we evaluated the prevalence, titers and impact of autoantibodies in Korean patients with HAV infection.

Methods: We retrospectively reviewed the electric medical records of 77 patients with hepatitis A at Konkuk University Hospital from August, 2005 to September, 2008. The presence and pattern of anti-nuclear antibody, anti-smooth muscle antibody, anti-mitochondrial antibody anti liver/kidney microsomal antibody were assessed by indirect immuno-fluorescence on Hep-2 cells and mouse/kidney section.

Results: Of the 73 patients with hepatitis A, 65 (89.0%) had positive indirect immuno-fluorescence tests. Of note, most of these patients (95.5%) showed a cytoplasmic pattern with filamentous staining of cytoplasmic fibers. There was no significant difference between groups in age or sex. In patients positive for autoantibodies, ALT and leukocyte count were significantly higher, while the increase in globulin was not statistically significant. In terms of titers, globulin was significantly higher in patients with ≥1:160 titers than with ≤1:80 (p value = 0.000).

Conclusions: Our study demonstrated a high prevalence of anti-cytoplasmic autoantibodies in patients with acute hepatitis A. This data would be useful to aid interpretation of indirect immunofluorescence testing in patients with acute hepatitis, especially in areas with a high prevalence of hepatitis A.