Interferon therapy in liver/kidney microsomal antibody type 1-positive patients with chronic hepatitis C

J Hepatol. 1994 Aug;21(2):199-203. doi: 10.1016/s0168-8278(05)80395-2.


The association between liver/kidney microsomal antibody type 1 and adult cases of hepatitis C virus-related chronic liver disease has been firmly established. In the presence of both markers, evidence of autoimmunity (liver/kidney microsomal antibody type 1) and actual viremia (serum HCV RNA), the therapeutic dilemma arises between steroids, which are beneficial to autoimmune but deleterious to viral diseases, and interferon-alpha, which may exacerbate an autoimmune disorder. Six patients with liver/kidney microsomal antibody type 1 and serum HCV RNA were given interferon-alpha: three showed a response pattern similar to that observed in autoantibody-negative chronic hepatitis C cases; the other three developed a sharp transaminase peak, which was not followed by HCV RNA clearance. Considering the brisk flare-up of liver cell necrosis, interferon-alpha treatment proved to be dangerous in the above three liver/kidney microsomal antibody type 1/HCV RNA positive cases. Subsequent steroid administration reduced alanine aminotransferase peaks, but may be harmful in viral infections. Therapeutic alternatives are needed: they will probably include pure antivirals (exerting no immunostimulatory effects) with or without immunosuppressive drugs.

MeSH terms

  • Adolescent
  • Adult
  • Alanine Transaminase / analysis
  • Autoantibodies / analysis*
  • Chronic Disease
  • Female
  • Hepacivirus / genetics
  • Hepatitis C / drug therapy*
  • Hepatitis C / immunology*
  • Hepatitis C / pathology
  • Humans
  • Interferon-alpha / therapeutic use*
  • Male
  • Middle Aged
  • RNA, Viral / analysis
  • RNA, Viral / blood
  • RNA, Viral / genetics


  • Autoantibodies
  • Interferon-alpha
  • RNA, Viral
  • anti-liver kidney microsome antibody
  • Alanine Transaminase