A retrospective study of prevalence and pattern of international consensus on ANA patterns among patients with hepatitis C virus infection

Abstract

Background A previous study reported a 30% prevalence of various autoantibodies among patients with hepatitis C virus (HCV) infection. The International Consensus on Anti-Nuclear Antibody (ANA) Patterns was recently introduced to classify ANA patterns based on immunoassay on HEp-2 cells. There is no previous report with this newly developed classification to evaluate patients with HCV infection. The study aims to study the prevalence and pattern of ANA patterns among HCV-infected patients. Methods We retrospectively analyzed the medical records of patients with HCV infection from September 2020 to June 2021 at our institution. A positive ANA is defined as a titer of more than 1:320. We compared patient features among the positive and negative groups. Results Overall, 258 patients were enrolled—184 patients with negative ANA and 74 patients (28.7%) with positive ANA. The mean age was 67.3 in ANA positive group and 61.2 ANA negative group. Female was prominent with ANA positive and accounted for 63.5%. The most detected ANA pattern was AC-1(homogeneous) (25.9%), followed by AC-4(fine speckled) (25.2%) and AC-21(anti-mitochondrial antibody) (9.6%). In ANA positive group, we found a trend of lower HCV viral load (5.72 log10 IU/ML vs. 6.02 log10 IU/ML), lower alanine aminotransferase level (39.5 U/L vs. 44 U/L), and higher advanced fibrosis (F3 and F4) (38.5% vs. 26.1%). In addition, higher positive ANA (more than 1:640) is significantly associated with lower estimated glomerular filtration rate (eGFR) (77.76 vs. 87.94 mL/min/1.73 m2, P = 0.044). Conclusions A high prevalence (28.7%) of ANA was found in patients with chronic hepatitis C. The presence of positive ANA is not related to the severity of their hepatic manifestation. However, higher positive ANA was significantly associated with lower eGFR.

Autoantibody Positivity in Chronic Hepatitis C Pre- and Post-Direct- Acting Antiviral Therapy: A Prospective Multicenter South Korean Study

“…(Hep-20-10 cells, cutoff 1:320), 21 showing that female sex (p = 0.023), older age (p = 0.001), lower HCV RNA titer (p = 0.06), and more advanced brosis (p = 0.098) were associated with ANA positivity. An American retrospective study that included 1,556 patients with CHC who underwent autoantibody testing during 1997-2016 reported that 388 patients (21.8%) showed ANA positivity, and that the proportion of women was higher and the rate of SVR was lower among the autoantibody-positive patients, although ANA positivity had no impact on the clinical outcomes.…”