Clinical impact of non-organ-specific autoantibodies on the response to combined antiviral treatment in patients with hepatitis C

Clin Infect Dis. 2005 Feb 15;40(4):501-7. doi: 10.1086/427285. Epub 2005 Jan 21.


Background: Hepatitis C virus (HCV)-related chronic hepatitis is frequently associated with non-organ-specific autoantibodies (NOSAs), but available data about the relationship between NOSA positivity and the effect of antiviral therapy in persons with hepatitis C are few and controversial. Our aim was to evaluate the impact of NOSA positivity on the outcome of combined antiviral therapy in HCV-positive patients.

Methods: A total of 143 consecutive adult patients with hepatitis C were studied. Antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-liver/kidney microsomal antibody type 1 (LKM1) were detected by indirect immunofluorescence. All patients were treatment naive and received combined antiviral therapy (interferon [IFN]-ribavirin) after enrollment in the study. Patients were classified as nonresponders if HCV RNA was detectable after 6 months of therapy, as relapsers if abnormal transaminase levels and reactivation of HCV replication were observed after the end of treatment, and as long-term responders if transaminase levels were persistently normal and HCV RNA was undetectable 6 months after the end of treatment.

Results: Thirty-seven patients (25%) were NOSA positive (SMA was detected in 19 patients, ANA in 10, ANA and SMA in 4, LKM1 in 3, and SMA and LKM1 in 1). The prevalence of long-term response was similar between NOSA-positive patients and NOSA-negative patients (48.6% vs. 56.6%; P=not significant). Compared with HCV genotype 1 (HCV-1), HCV genotypes other than 1 were more often associated with long-term response among NOSA-positive patients (93.3% vs. 30%; P=.0017). The overall rate of long-term response, irrespective of NOSA status, was 54.5%. Detection of HCV-1 and elevated gamma-glutamyl transpeptidase serum levels were independent negative prognostic factors of treatment response (P=.007 and P=.026, respectively).

Conclusions: Combined antiviral treatment (IFN-ribavirin) is safe and effective in NOSA-positive patients with hepatitis C, even if long-term response is less likely in those infected with HCV-1.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / immunology
  • Antibody Specificity
  • Antiviral Agents / therapeutic use*
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Drug Therapy, Combination
  • Female
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / immunology*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Male
  • Muscle, Smooth / immunology
  • Polyethylene Glycols
  • RNA, Viral / blood
  • Recombinant Proteins
  • Ribavirin / therapeutic use*
  • Treatment Outcome


  • Antibodies, Antinuclear
  • Antiviral Agents
  • Autoantibodies
  • Interferon alpha-2
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins
  • anti-liver kidney microsome antibody
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2b