Background/Purpose:

Hepatitis C infection (HCV) is a leading cause of chronic liver disease. It is associated with a plethora of autoimmune manifestations including clinical, serological and pathological abnormalities affecting different organs. Immune dysregulation in HCV is further indicated by the high prevalence of non-organ specific antibodies. We investigated the autoimmune manifestations in HCV including clinical, laboratory, imaging and pathological data with emphasis on serologies.

Methods:

We conducted a retrospective chart review in Rheumatology clinic on patients with HCV (confirmed by viral RNA) as a cofactor. We collected the demographic, clinical, laboratory, imaging and pathological data on these patients. We investigated the extent of autoimmune manifestations and its correlation to the degree of hepatic damage.

Results:

We obtained data on 29 patients of whom a limited number had available serological data. 41.3% had a coexisting autoimmune disease with Rheumatoid arthritis (RA) as the most common (33.3%). Arthralgia and Raynaud’s were seen in 79.3% and 10.3% respectively. A positive ANA was demonstrated in 61.5% and ENA was demonstrated in 22.2%. Smith and RNP antibodies were detected in 25% and 50% respectively in the absence of clinical Lupus. ANCA was detected in 20% and cryoglobulins in 28% in the absence of clinical vasculitis. Rheumatoid Factor (RF) and Anti-CCP were seen in 45% and 22.2% respectively. 22.2% of patients with RF and 5.5% of patients with Anti-CCP did not have clinical RA. Antiphospholipid antibodies were seen in 40% in the absence of thromboembolic disease. Serologies were confounded by illicit drugs in 20%. The severity of autoimmune manifestations and serological abnormalities did not track the severity of hepatic damage.

Conclusion:

Significant autoimmune manifestations including serological abnormalities and cryoglobulinemia can be seen in hepatitis C in the absence of a clinical disease. Autoimmune manifestations do not parallel the degree of hepatic damage in hepatitis C.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/autoimmune-manifestations-in-hepatitis-c-a-single-centered-experience/