Serological and clinical markers of autoimmune disease in hcv-infected subjects with different disease conditions

G. Valentini¹, A. Mantelli¹, M. Persico², C. Tuccillo³, G. Del Vecchio Blanco³, F. Morisco³, R.D.G. Improta¹, S. Migliaresi¹, L. Gualdieri¹, N. Caporaso<sup>3

1</sup>Institute of Clinical Medicine and Rheumatology; ²Internal Medicine and Hepatology Unit; and ³F. Magrassi Gastroenterology Unit, Department of Internal and Experimental Medicine, School of Medicine of the Second University of Naples, Naples, Italy.


ABSTRACT
Objective
To investigate whether the serological markers of autoimmunity and the clinical features of autoimmune disease which occur in hepatitis C virus (HCV)-infected subjects are correlated to each other and/or to the clinical pattern of the disease.

Methods
Seventeen symptom-free, anti-HCV antibody positive subjects, 17 patients with chronic hepatitis C, 21 patients with mixed cryoglobulinemia (MC), and as controls 17 anti-HCV negative patients with dyspepsia were enrolled in a prospective study. A patient history, clinical examination, self-administered questionnaire and laboratory investigations (hepatic enzyme levels, serum HCV-RNA and anti-HCV antibody testing, and serum autoantibody profile) were performed to detect liver and/or autoimmune disease.

Results
Serological markers of autoimmunity and clinical findings of autoimmune disease were found to be more frequent in the HCV-infected patients considered as a whole than in controls. However, rheumatoid factor and clinical findings of autoimmune disease were more frequent in MC patients, while anti-smooth muscle antibodies not linked to symptoms or signs of autoimmune disease were detected in all groups of HCV-infected individuals, including healthy carriers and subjects who had recovered from a previous HCV infection.

Conclusion
Anti-smooth muscle antibodies, a serological marker of autoimmunity, are detectable in HCV-infected subjects whatever their clinical status. Clinical findings of autoimmune disease prevalently occur in patients with mixed cryoglobulinemia.

Key words
Autoimmunity, anti-smooth muscle antibodies, hepatitis C virus, mixed cryoglobulinemia.

Gabriele Valentini, MD, Associate Professor of Rheumatology; Annalisa Mantelli, MD, Fellow in Rheumatology; Marcello Persico, MD, Assistant Professor of Internal Medicine; Concetta Tuccillo, MS, Researcher in Virology; Giovanna Del Vecchio Blanco, MD, Fellow in Gastroenterology; Filomena Morisco, MD, Fellow in Gastroenterology; Raffaele D.G. Improta, MD, Investigator in Rheumatology; Sergio Migliaresi, MD, Assistant Professor of Rheumatology; Luciano Gualdieri, MD, Investigator in Internal Medicine; Nicola Caporaso, MD, Professor of Gastroenterology.

Please address correspondence and reprint requests to: Gabriele Valentini, MD, Policlinico, Via Pansini no. 5, 80131 Napoli, Italy.

Received on April 14, 1998; accepted in revised form on September 22, 1998.

Clinical and Experimental Rheumatology 1999; 17: 75-79.
© Copyright Clinical and Experimental Rheumatology 1999.