Useful biomarkers for assessment of hepatitis C virus infection-associated autoimmune disorders

Abstract

During the course of chronic hepatitis C virus (HCV) infection, various extrahepatic manifestations of autoimmune disorders may occur, including arthralgia/arthritis, sicca complex, purpura, cutaneous ulcer, and thyroid dysfunction. In addition, the prevalence of circulating autoantibodies is high among patients with HCV infection. Commonly detected autoantibodies in HCV-infected patients include rheumatoid factor, antinuclear antibody, anti-SSA/anti-SSB antibody, cryoglobulin, antineutrophil cytoplasmic antibody, anti-smooth muscle antibody, anti-liver and anti-thyroid autoantibodies. These autoantibodies may be associated with underlying autoimmune disorders or liver inflammation in HCV infection. A possible reason for antibody production is overactivation and proliferation of B lymphocytes, via the interaction with the surface protein of HCV. Because immunotherapy can cause HCV flare-up or liver damage, overdiagnosis of HCV-related autoimmune symptoms as primary autoimmune disorders should be avoided. This review describes biomarkers that are useful in clinically evaluating autoimmune manifestations and disorders associated with HCV infection.

Clinical relevance of serum non‐organ‐specific antibodies in patients with HCV infection receiving direct‐acting antiviral therapy

“…On the bases of these results, autoantibodies could be considered HCV‐related epiphenomena other than part of immune‐based disease . This hypothesis may be supported by our multivariate analysis, which showed a significant correlation between autoantibody negativity following antiviral therapy and the absence of hepatic hilar lymphadenopathy.…”

“…Chronic hepatitis C virus (HCV) infection has been considered a major cause of mortality, morbidity, and resource utilisation in the world . About 40%‐70% of HCV patients develop at least an autoimmune extrahepatic disorder, presumably due to the interaction between HCV E2 envelope protein and B lymphocyte CD‐81 receptor . In addition, the same interaction is responsible for the production of different serum non‐organ‐specific antibodies (NOSA), such as anti‐nuclear (ANA), anti‐smooth muscle (ASMA), and anti‐liver‐kidney microsome (LKM) antibodies .…”

“…The clinical significance of this phenomenon has not been fully understood, except for the presence of LKM‐1 antibody, which is linked to a molecular mimicry between the cytochrome enzyme CYP2D6, primarily expressed in the liver, and HCV proteins in genetically predisposed subjects . Despite the high prevalence of circulating autoantibodies in HCV patients, a liver‐specific autoimmune disorder has been found in very few cases, especially when a persistent elevation of liver cytolytic and/or cholestatic enzymes occurs even after an effective antiviral therapy …”

Developing a vaccine for Type 1 diabetes through targeting enteroviral infections

“…Autoimmune phenomena are common in chronic virus infections where it is difficult to distinguish the autoimmune, anti-viral and inflammation components of the immune response. For example, hepatitis C virus infection is associated with autoantibodies and T-cell infiltration in the infected liver [76]. Since the potential of EV vaccines or antiviral drugs in the prevention of T1D has never been tested, they are currently among the most attractive candidates to be studied in clinical prevention trials.…”

Extrahepaticus manifesztációk idült hepatitis C-vírus-fertőzöttekben

“…típusú cryoglobulinaemia következtében kialakuló szisztémás vasculitis bőr-, vese-, valamint ízületi érintettséggel. Az extrahepaticus tünetek másik csoportjának hátterében nem a cryoglobulinaemia áll, szerepe lehet a vírusfehérjék és a gazdaszervezet fehérjéi közötti mimikrinek, immunreakcióknak, valamint a vírus replikációjának, direkt hatásának az adott szervben, szövetben [8,9], amely szövetek a vírus rezervoár-jául is szolgálnak, s később a fertőzés perzisztálását, reaktivációját magyarázzák [6].…”