G. VERUCCHI, M LENZI*, L ATTARD, P MURATORI*, S DIOTALLEVI, R MINERO§, F GUZZO, F BIANCHI*, F CHIODO Dep.of Clinical and Experimental-Division of Infectious Diseases-University of Bologna, *Internal Medicine - University of Bologna, § Dep. of Clinical Pathology- S.Orsola Hospital - Bologna - Italy

The relationship between hepatitis virus infections (HCV and HBV) and autoimmune phenomena (ANA, SMA, anti-LKM1, anti-LC1, a ti-Thyroid-Peroxidase-anti-TPO and anti-Thyroglobulin-anti-TG) are still poorly investigated in children.

Aim of the study:
to assess the prevalence of non organ and organ specific autoantibodies in a retrospective series of children with HCV and HBV-chronic infection.

Patients and Methods:
36 patients with anti-HCV and HCV-RNA positive chronic hepatitis (18 males, 18 females) with a median age of 8.9 years (range 2-15,8) were studied, Twenty-two patients received blood or plasma transfusion, 11 were borm from anti-HCV positive mothers,one had major surgery and in two the route of infection was unknown. As a control group, sera from 42 children (23M/19F) (median age 9,4 years-range 2,5-15,11) with HBV infection (33 HBV-DNA positive) were considered. Sera were tested at a dilution of 1:20 on liver, kidney and stomach cryostat sections and on Hep-2 cell. Anti-LC1 antibody was tested by CIE with rat liver cytosol as source of antigen. Anti-Thyroid Peroxidase and anti-Thyroglobulin antibodies were tested by a commercially RIA-Kit. Results: non organ-specific autoantibodies were detected in 10 out of 36 patients with HCV infection (28%) and in 5 out of 42 children with HBV infection (12%). The prevalence of each autoantibodies is shown in the table

                          HCV (36)    HBV (42)
     ANA (speckled)       1     3%    2     5%
     SMA (non anti-actin) 5    14%    3     7%
     Anti-LKM1            4    11%    0     -
     Anti-LC1             0     -     0     -
     Anti-TPO            1/29   3%   0/27   -
     Anti-TG             0/29   -    0/27   -

Clinical and biochermical differences did not emerge between autoantibodies positive and negative patients. No specific association was found between HCV genotypes and one of the autoantibodies studied. Four (3 SMA, 1 ANA) out of 12 patients with HCV chronic hepatitis and 1 (ANA) out of 19 children with HBV chronic hepatitis who underwent interferon therapy developed low titres of autoantibodies under treatment.

These results demonstrate that overall prevalence of non organ specific autoantibodies is higher in children with HCV -related chronic hepatitis than that observed in HBV -related ones, and similar to that observed in adults. The autoantibodies specificities typical of autoimmune hepatitis were never observed in these patients. Anti-LKM1 reactivity is specific of anti-HCV infection and its prevalence is higher than that reported in adults.

Source: American Association for the Study of Liver Diseases - 1996 Annual Meeting

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