Smooth muscle antibodies and cryoglobulinemia are associated with advanced liver fibrosis in Brazilian hepatitis C virus carriers

Andrade, Luís Jesuíno de Oliveira; Melo, Paulo Roberto Santana de; Atta, Ajax Mercês; Atta, Maria Luiza Brito de Sousa; Jesus, Larissa Santana de; Sousa, Gabriel Menezes de; Silva, Carolina Alves Costa; Paraná, Raymundo

doi:10.1016/s1413-8670(11)70142-8

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…Previous studies, as well as the current study, have shown that in Brazil and worldwide, hepatitis C more commonly affects individuals who are between the fourth and fifth decades of life (38 to 42%) 21,22 ; in addition, the majority of those affected are male (60.5 to 76%) 21,23 , and cirrhosis is present in 4 to 21% of patients 3,24 . In Brazil, HCV genotype 1 is associated with prevalence rates that vary between 50.3 and 88.5%, while genotype 2, which was not detected in this study, has a lower prevalence rate that ranges between 0.7 and 8.8% 25 .…”

Section: Discussionsupporting

confidence: 66%

Autoantibody profile in individuals with chronic hepatitis C

Marconcini

Fayad

Shiozawa

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction: Autoantibodies are often produced during infection with chronic hepatitis C virus (HCV), but it remains controversial whether they influence the biochemical profile and histological features of this disease. Therefore, this current study sought to describe these autoantibodies and evaluate their impact on the clinical and histological presentation of hepatitis C. Methods: This cross-sectional analytical study assessed patients with HCV (RNA+) from October 2011 to July 2012. Results: This study included 66 patients, with a mean age of 53.2±10.5 years. Of these patients, 60.6% were male, and 54.3% presented with genotype 1. Non-organ-specific autoantibodies (NOSA) were detected in 24% of the patients; of these, 7.6% were anti-mitochondrial antibodies (AMA+), 26.7% were anti-smooth muscle antibodies (SMA+) and 6.8% were liver kidney microsomal type 1 antibodies (LKM1+). With respect to the thyroid autoantibodies, 7.4% were anti-peroxidase (ATPO+) antibodies, and none were anti-thyroglobulin (ATG+) antibodies. Regarding celiac disease autoantibodies, 5.8% were endomysial antibodies (EMA+), and no transglutaminase (TTG+) antibodies were detected. Cryoglobulins were found in 2.1% of patients. When NOSA+ individuals were compared to patients without the presence of NOSAs, they exhibited higher median alkaline phosphatase (0.7 vs. 0.6 xULN; p=0.041), lower median platelet counts (141,500.0 vs. 180,500.0/mm 3 ; p=0.036), lower mean prothrombin activity (72.6±11.5% vs. 82.2±16.0%; p=0.012) and an increased prevalence of significant fibrosis (E≥2) (45.5% vs. 18.2%; p=0.012). There was also a tendency for a greater proportion of NOSA+ cases to have marked periportal activity (APP≥3) (44.5% vs. 15.6%; p=0.087). Conclusions: In addition to the high prevalence of autoantibodies associated with HCV infection, it was observed that NOSA positivity was associated with a more severe histological and biochemical profile of hepatitis C infection.

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Section: Discussionsupporting

confidence: 66%

Autoantibody profile in individuals with chronic hepatitis C

Marconcini

Fayad

Shiozawa

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…We had previously demonstrated that advanced stage of fibrosis in Brazilian patients is associated with cryoglobulinemia. 21 …”

Section: Discussionmentioning

confidence: 99%

Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Oliveira

Cabral

Jesus

et al. 2014

The Brazilian Journal of Infectious Diseases

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Hepatitis C virus (HCV) infects B-lymphocytes, provokes cellular dysfunction and causes lymphoproliferative diseases such as cryoglobulinemia and non-Hodgkin's B-cell lymphoma. In the present study, we investigated the serum levels of kappa and lambda free light chains (FLC) of immunoglobulins and the kappa/lambda FLC ratio in Brazilian patients with chronic HCV infection and cryoglobulinemia. We also analyzed the immunochemical composition of the cryoglobulins in these patients. Twenty-eight cryoglobulinemic HCV patients composed the target group, while 37 HCV patients without cryoglobulinemia were included as controls. The median levels of kappa and lambda FLC were higher in patients with cryoglobulinemia compared to controls (p=0.001 and p=0.003, respectively), but the kappa/lambda FLC ratio was similar in patients with and without cryoglobulinemia (p>0.05). The median FLC ratio was higher in HCV patients presenting with advanced fibrosis of the liver compared to HCV patients without fibrosis (p=0.004). Kappa and lambda FLC levels were strongly correlated with the IgA, IgG and IgM levels in the patients with cryoglobulinemia. In patients without cryoglobulinemia, the kappa FLC level was only correlated with the IgG level, whereas the lambda FLC were weakly correlated with the IgA, IgG and IgM levels. An immunochemical pattern of mixed cryoglobulins (MC), predominantly IgM, IgG, IgA and kappa light chain, was verified in these immune complexes. We concluded that HCV-infected patients presenting cryoglobulinemia have vigorous polyclonal B-lymphocyte activation due to chronic HCV infection and persistent immune stimulation.

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Impact of treatment with direct‐acting antivirals on inflammatory markers and autoantibodies in HIV/HCV co‐infected individuals

Rossotti

Merli

Baiguera

et al. 2023

Journal of Viral Hepatitis

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HCV infection could have extrahepatic manifestations due to an aberrant immune response. HCV/HIV co‐infection increases such persistent immune activation. Aim of the present study is to describe the evolution of inflammatory markers used in clinical practice, mixed cryoglobulinemia (MC) and autoantibody reactivity in co‐infected individuals who achieved sustained virological response (SVR) after DAA treatment. This prospective, observational study included all HIV/HCV co‐infected subjects who started any DAA regimen from 2015 to 2020. Samples for laboratory measurements (ferritin, C reactive protein, C3 and C4 fractions, rheumatoid factor, MC, anti‐thyroglobulin Ab, anti‐thyroid peroxidase Ab, ANCA, ASMA, anti‐LKM, anti‐DNA, AMA, ANA, T CD4+ and CD8+ cell count, and CD4/CD8 ratio) were collected at baseline, after 4 weeks, at end of treatment, and at SVR12. The analysis included 129 individuals: 51.9% with a F0–F3 fibrosis and 48.1% with liver cirrhosis. Cryocrit, C3 fraction, and rheumatoid factor significantly improved at week 4; ferritin, anti‐thyroglobulin Ab, and C4 fraction at EOT; total leukocytes count at SVR12. MC positivity decreased from 72.8% to 35.8% (p < .001). T CD4+ cell slightly increased at SVR12, but with an increase also in CD8+ resulting in stable CD4/CD8 ratio. Autoantibody reactivity did not change significantly. ANA rods and rings positivity increased from 14.8% to 28.6% (p = .099): they were observed in three subjects without exposure to RBV. DAA therapy may lead to improvement in inflammatory markers and MC clearance but without significant changes in autoantibodies reactivity and CD4/CD8 ratio over a follow up of 12 weeks.

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Smooth muscle antibodies and cryoglobulinemia are associated with advanced liver fibrosis in Brazilian hepatitis C virus carriers

Cited by 5 publications

References 12 publications

Autoantibody profile in individuals with chronic hepatitis C

Autoantibody profile in individuals with chronic hepatitis C

Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia

Impact of treatment with direct‐acting antivirals on inflammatory markers and autoantibodies in HIV/HCV co‐infected individuals

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