Effect of Autoantibody on the Therapeutic Effect and Safety for Chronic Hepatitis C_West China Medical Journal

Authors：

 WuQin ¹ ,  LeiXuezhong ¹ , WeiXiutian ¹ , WangCong ² , LiZhenzhen ²

1. Infectious Diseases Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, R. R. China;
2. West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, R. R. China;

Corresponding?author：

LeiXuezhong, Email: lxzy1117@sina.com

Keywords：

Chronic hepatitis C; Autoantibody; Peg-Interferon; Ribavirin; Safety

DOI：

10.7507/1002-0179.201600372

Video：

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Objective To evaluate the effect of autoantibody on the efficacy and safety of pegylated interferonα-2a (Peg-IFNα-2a) and ribavirin on chronic hepatitis C (HCV). Methods We enrolled 106 chronic HCV infected patients, who were divided into autoantibody-positive group and negative group based on the baseline autoantibody detection. The patients were treated for 48 weeks. The anti-viral response and adverse effects were observed. Data analyses were reported using the SPSS 20.0 statistical package. Results The prevalence of any autoantibody in chronic hepatitis C patients amounted to 31.1%, and serum anti-nuclear antibody was positive in 24 patients. Difference in age, sex, serum alanine transaminase level, aspartate transaminase level, total bilirubin level, thyroid function and HCV RNA level between autoantibody-positive group and negative group was not significant (P > 0.05). The level of hemoglobin in autoantibody-positive group was significantly lower than the negative group (P=0.018). Of the 106 patients, 82 patients achieved sustained virological response (SVR), 56 achieved rapid virological response (RVR), 98 achieved ealy virological response (EVR) and 8 were non-responders. There were no significant differences between RVR, EVR and SVR in autoantibody-positive group and negative group (P > 0.05). The most common adverse effects in this study were fatigue, weight loss, hair loss and fever, and no significant differences in adverse effects were observed between the two groups (P > 0.05). Conclusion Autoantibody positivity may not affect the treatment response and is safe in chronic HCV infected patients with combination therapy of pegylated interferonα-2a plus ribavirin.

Citation： WuQin, LeiXuezhong, WeiXiutian, WangCong, LiZhenzhen. Effect of Autoantibody on the Therapeutic Effect and Safety for Chronic Hepatitis C. West China Medical Journal, 2016, 31(8): 1363-1366. doi: 10.7507/1002-0179.201600372 Copy

1.	Kajiyama Y, Kikuchi K, Takai A, et al. B-cell-activating factor affects the occurrence of thyroid autoimmunity in chronic hepatitis C patients treated with interferon alpha[J]. Clin Dev Immunol, 2012, 2012(12):158-163.
2.	B?ckle B C, Baltaci M, Ratzinger G, et al. Hepatitis C and autoimmunity:a therapeutic challenge[J]. J Intern Med, 2012, 271(1):104-106.
3.	Yee L J, Kelleher P, Goldin RD, et al. Antinuclear antibodies (ANA) in chronic hepatitis C virus infection:correlates of positivity and clinical relevance[J]. J Viral Hepat, 2004, 11(5):459-464.
4.	Mandelli L, Kim JJ, Serretti A, et al. Clinical impact of non-organ-specific autoantibodies on the response to combined antiviral treatment in patients with hepatitis C[J]. Clin Infect Dis, 2005, 40(4):501-507.
5.	Muratori P, Muratori L, Verucchi G, et al. Non-organ-specific autoantibodies in children with chronic hepatitis C:clinical significance and impact on interferon treatment[J]. Clin Infect Dis, 2003, 37(37):1320-1326.
6.	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[J]. BMC Infect Dis, 2004, 4(1):4.
7.	中華預防醫學會醫院感染控制分會.中國丙型病毒性肝炎醫院感染防控指南[J].中國肝臟病雜志:電子版, 2013, 26(2):71-75.
8.	Chen CH, Lee CM, Chen CH, et al. Prevalence and clinical relevance of serum autoantibodies in patients with chronic hepatitis C[J]. Chang Gung Med J, 2010, 33(3):258-265.
9.	Gatselis NK, Georgiadou SP, Tassopoulos N, et al. Impact of parietal cell autoantibodies and non-organ-specific autoantibodies on the treatment outcome of patients with hepatitis C virus infection:a pilot study[J]. World J Gastroenterol, 2005, 11(4):482-487.
10.	李雅馨, 楊彥佳, 楊梅, 等.聚乙二醇干擾素α-2a聯合利巴韋林治療自身免疫抗體陽性慢性丙型肝炎的臨床療效[J].中華肝臟病雜志, 2013, 21(5):345-347.
11.	Bayraktar Y, Bayraktar M, Gurakar A, et al. A comparison of the prevalence of autoantibodies in individuals with chronic hepatitis C and those with autoimmune hepatitis:the role of interferon in the development of autoimmune diseases[J]. Hepatogastroenterology, 1997, 44(14):417-425.
12.	Zauli D, Cassani F, Bianchi FB. Auto-antibodies in hepatitis C[J]. Biomed Pharmacother, 1999, 53(5):234-241.
13.	Cacoub P, Renou C, Rosenthal E, et al. Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321 patients. The GERMIVIC. Groupe d'Etude et de Recherche en Medecine Interne et Maladies Infectieuses sur le Virus de l'Hepatite C[J]. Medicine (Baltimore), 2000, 79(1):47-56.
14.	Clifford BD, Donahue D, Smith L, et al. High prevalence of serological markers of autoimmunity in patients with chronic hepatitis C[J]. Hepatology, 1995, 21(3):613-619.
15.	Thimme R, Bukh J, Spangenberg HC, et al. Viral and immunological determinants of hepatitis C virus clearance, persistence, and disease[J]. Proc Natl Acad Sci USA, 2002, 99(24):15661-15668.
16.	李新華, 侯寶國.慢性丙型肝炎患者干擾素治療前后血清自身抗體變化的臨床觀察[J].華西醫學, 2010, 25(11):2022-2024.
17.	Hsieh MY, Dai CY, Lee LP, et al. Antinuclear antibody titer and treatment response to peginterferon plus ribavirin for chronic hepatitis C patients[J]. Kaohsiung J Med Sci, 2012, 28(2):86-93.
18.	Longman RS, Talal AH, Jacobson IM, et al. Presence of functional dendritic cells in patients chronically infected with hepatitis C virus[J]. Blood, 2004, 103(3):1026-1029.

1. Kajiyama Y, Kikuchi K, Takai A, et al. B-cell-activating factor affects the occurrence of thyroid autoimmunity in chronic hepatitis C patients treated with interferon alpha[J]. Clin Dev Immunol, 2012, 2012(12):158-163.
2. B?ckle B C, Baltaci M, Ratzinger G, et al. Hepatitis C and autoimmunity:a therapeutic challenge[J]. J Intern Med, 2012, 271(1):104-106.
3. Yee L J, Kelleher P, Goldin RD, et al. Antinuclear antibodies (ANA) in chronic hepatitis C virus infection:correlates of positivity and clinical relevance[J]. J Viral Hepat, 2004, 11(5):459-464.
4. Mandelli L, Kim JJ, Serretti A, et al. Clinical impact of non-organ-specific autoantibodies on the response to combined antiviral treatment in patients with hepatitis C[J]. Clin Infect Dis, 2005, 40(4):501-507.
5. Muratori P, Muratori L, Verucchi G, et al. Non-organ-specific autoantibodies in children with chronic hepatitis C:clinical significance and impact on interferon treatment[J]. Clin Infect Dis, 2003, 37(37):1320-1326.
6. 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[J]. BMC Infect Dis, 2004, 4(1):4.
7. 中華預防醫學會醫院感染控制分會.中國丙型病毒性肝炎醫院感染防控指南[J].中國肝臟病雜志:電子版, 2013, 26(2):71-75.
8. Chen CH, Lee CM, Chen CH, et al. Prevalence and clinical relevance of serum autoantibodies in patients with chronic hepatitis C[J]. Chang Gung Med J, 2010, 33(3):258-265.
9. Gatselis NK, Georgiadou SP, Tassopoulos N, et al. Impact of parietal cell autoantibodies and non-organ-specific autoantibodies on the treatment outcome of patients with hepatitis C virus infection:a pilot study[J]. World J Gastroenterol, 2005, 11(4):482-487.
10. 李雅馨, 楊彥佳, 楊梅, 等.聚乙二醇干擾素α-2a聯合利巴韋林治療自身免疫抗體陽性慢性丙型肝炎的臨床療效[J].中華肝臟病雜志, 2013, 21(5):345-347.
11. Bayraktar Y, Bayraktar M, Gurakar A, et al. A comparison of the prevalence of autoantibodies in individuals with chronic hepatitis C and those with autoimmune hepatitis:the role of interferon in the development of autoimmune diseases[J]. Hepatogastroenterology, 1997, 44(14):417-425.
12. Zauli D, Cassani F, Bianchi FB. Auto-antibodies in hepatitis C[J]. Biomed Pharmacother, 1999, 53(5):234-241.
13. Cacoub P, Renou C, Rosenthal E, et al. Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321 patients. The GERMIVIC. Groupe d'Etude et de Recherche en Medecine Interne et Maladies Infectieuses sur le Virus de l'Hepatite C[J]. Medicine (Baltimore), 2000, 79(1):47-56.
14. Clifford BD, Donahue D, Smith L, et al. High prevalence of serological markers of autoimmunity in patients with chronic hepatitis C[J]. Hepatology, 1995, 21(3):613-619.
15. Thimme R, Bukh J, Spangenberg HC, et al. Viral and immunological determinants of hepatitis C virus clearance, persistence, and disease[J]. Proc Natl Acad Sci USA, 2002, 99(24):15661-15668.
16. 李新華, 侯寶國.慢性丙型肝炎患者干擾素治療前后血清自身抗體變化的臨床觀察[J].華西醫學, 2010, 25(11):2022-2024.
17. Hsieh MY, Dai CY, Lee LP, et al. Antinuclear antibody titer and treatment response to peginterferon plus ribavirin for chronic hepatitis C patients[J]. Kaohsiung J Med Sci, 2012, 28(2):86-93.
18. Longman RS, Talal AH, Jacobson IM, et al. Presence of functional dendritic cells in patients chronically infected with hepatitis C virus[J]. Blood, 2004, 103(3):1026-1029.

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