Identification of hepatitis A virus as a trigger for autoimmune chronic hepatitis type 1 in susceptible individuals

Lancet. 1991 May 18;337(8751):1183-7. doi: 10.1016/0140-6736(91)92858-y.

Abstract

To identify factors contributing to the pathogenesis of autoimmune chronic active hepatitis (CAH) healthy relatives of 13 patients with the disorder were followed prospectively for 4 years. 58 relatives were monitored for various serological markers and for T-lymphocyte migration inhibitory activity every 2 months. 3 cases of subclinical acute hepatitis A occurred during the study. In 2 of the 3 subjects, before hepatitis A virus (HAV) infection, there was a defect in suppressor-inducer T lymphocytes specifically controlling immune responses to the asialoglycoprotein receptor, an antigen expressed on the hepatocyte surface. In these 2 subjects, specific helper T cells and antibodies to the asialoglycoprotein receptor persisted and increased after acute hepatitis A, and autoimmune CAH type 1 developed within 5 months. Thus, in susceptible individuals HAV is a trigger for autoimmune CAH.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antibodies, Viral / biosynthesis
  • Antibodies, Viral / blood
  • Asialoglycoprotein Receptor
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / microbiology
  • Biomarkers / blood
  • Hepatitis A / immunology*
  • Hepatitis A / microbiology
  • Hepatitis, Chronic / immunology*
  • Hepatitis, Chronic / microbiology
  • Hepatovirus / physiology*
  • Humans
  • Leukocyte Migration-Inhibitory Factors / physiology
  • Prospective Studies
  • Receptors, Immunologic / immunology
  • T-Lymphocytes, Helper-Inducer / physiology
  • T-Lymphocytes, Regulatory / physiology

Substances

  • Antibodies, Viral
  • Asialoglycoprotein Receptor
  • Biomarkers
  • Leukocyte Migration-Inhibitory Factors
  • Receptors, Immunologic
  • Alanine Transaminase