Frequency and significance of antibody to hepatitis C virus in severe corticosteroid-treated cryptogenic chronic active hepatitis

A. J. Czaja, H. F. Taswell, Jorge Rakela, C. M. Schimek

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Abstract

To determine the frequency and significance of antibody to hepatitis C virus (anti-HCV) in severe cryptogenic chronic active hepatitis (CAH), we tested sera from 17 corticosteroid-treated patients by an enzyme immunoassay. Specificity of the antibodies to HCV-encoded antigens was assessed by recombinant immunoblot assay. The findings in patients with and without anti-HCV were contrasted, and the frequency of seropositivity was compared with that in patients who had other types of chronic liver disease and in normal adults. Only three patients (18%) with severe cryptogenic CAH had anti-HCV. Sera from two of these patients were reactive by recombinant immunoblot assay; the other sample produced an indeterminate reaction. The frequency of seropositivity in patients with cryptogenic disease was not statistically different from that in patients with autoimmune CAH (6%), hepatitis B surface antigen-positive CAH (9%), or alcoholic liver disease (0%), but it was significantly less than in those with posttransfusion CAH (18% versus 75%; P < 0.01). Seropositive patients tended to have lower serum aspartate aminotransferase, γ-globulin, and bilirubin levels than seronegative counterparts, and they did not have histologic features of confluent necrosis at initial assessment. Two of the three seropositive patients, both of whom had been reactive by recombinant immunoblot assay, entered remission during therapy, and one, with an indeterminate reaction, died of liver failure. We conclude that anti-HCV occurs infrequently in severe corticosteroid-treated cryptogenic CAH. Seropositive patients may have less severe inflammatory activity than seronegative counterparts. Cryptogenic disease may improve during corticosteroid treatment, a result suggesting an underlying immunologic disorder in some patients.

Original languageEnglish (US)
Pages (from-to)1303-1313
Number of pages11
JournalMayo Clinic Proceedings
Volume65
Issue number10
StatePublished - 1990

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Hepatitis C Antibodies
Chronic Hepatitis
Adrenal Cortex Hormones
Hepatitis Antibodies
Serum
Autoimmune Hepatitis
Alcoholic Liver Diseases
Antibody Specificity
Globulins
Liver Failure
Hepatitis B Surface Antigens
Aspartate Aminotransferases
Immunoenzyme Techniques
Bilirubin
Hepacivirus
Liver Diseases
Chronic Disease
Necrosis

ASJC Scopus subject areas

  • Medicine(all)

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Frequency and significance of antibody to hepatitis C virus in severe corticosteroid-treated cryptogenic chronic active hepatitis. / Czaja, A. J.; Taswell, H. F.; Rakela, Jorge; Schimek, C. M.

In: Mayo Clinic Proceedings, Vol. 65, No. 10, 1990, p. 1303-1313.

Research output: Contribution to journalArticle

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abstract = "To determine the frequency and significance of antibody to hepatitis C virus (anti-HCV) in severe cryptogenic chronic active hepatitis (CAH), we tested sera from 17 corticosteroid-treated patients by an enzyme immunoassay. Specificity of the antibodies to HCV-encoded antigens was assessed by recombinant immunoblot assay. The findings in patients with and without anti-HCV were contrasted, and the frequency of seropositivity was compared with that in patients who had other types of chronic liver disease and in normal adults. Only three patients (18{\%}) with severe cryptogenic CAH had anti-HCV. Sera from two of these patients were reactive by recombinant immunoblot assay; the other sample produced an indeterminate reaction. The frequency of seropositivity in patients with cryptogenic disease was not statistically different from that in patients with autoimmune CAH (6{\%}), hepatitis B surface antigen-positive CAH (9{\%}), or alcoholic liver disease (0{\%}), but it was significantly less than in those with posttransfusion CAH (18{\%} versus 75{\%}; P < 0.01). Seropositive patients tended to have lower serum aspartate aminotransferase, γ-globulin, and bilirubin levels than seronegative counterparts, and they did not have histologic features of confluent necrosis at initial assessment. Two of the three seropositive patients, both of whom had been reactive by recombinant immunoblot assay, entered remission during therapy, and one, with an indeterminate reaction, died of liver failure. We conclude that anti-HCV occurs infrequently in severe corticosteroid-treated cryptogenic CAH. Seropositive patients may have less severe inflammatory activity than seronegative counterparts. Cryptogenic disease may improve during corticosteroid treatment, a result suggesting an underlying immunologic disorder in some patients.",
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