Autoantibodies and hepatitis C virus genotypes in chronic hepatitis C patients in Estonia

AIM: To determine the prevalence of several autoantibodies in chronic hepatitis C patients, and to find out whether the pattern of autoantibodies was associated with hepatitis C virus (HCV) genotypes. METHODS: Sera from 90 consecutive patients with chronic hepatitis C were investigated on the presence of anti-nuclear (ANA), anti-mitochondrial (AMA), anti-smooth muscle (SMA), anti-liver-kidney microsomal type 1 (LKMA1), anti-parietal cell (PCA), anti-thyroid microsomal (TMA), and anti-reticulin (ARA) autoantibodies. The autoantibodies were identified by indirect immunofluorescence. HCV genotypes were determined by a restriction fragment length polymorphism analysis of the amplified 5' noncoding genome region. RESULTS: Forty-six (51.1%) patients were positive for at least one autoantibody. Various antibodies were presented as follows: ANA in 13 (14.4%) patients, SMA in 39 (43.3%), TMA in 2 (2.2%), and ARA in 1 (1.1%) patients. In 9 cases, sera were positive for two autoantibodies (ANA and SMA). AMA, PCA and LKMAI were not detected in the observed sera. HCV genotypes were distributed as follows: 1b in 66 (73.3%) patients, 3a in 18 (20.0%), and 2a in 6 (6.7%) patients. CONCLUSION: A high prevalence of ANA and SMA can be found in chronic hepatitis C patients. Autoantibodies are present at low titre (1:10) in most of the cases. Distribution of the autoantibodies show no differences in the sex groups and between patients infected with different HCV genotypes.

Chronic hepatitis C in hemodialysis patients:Prevalence and liver fibrosis impact in the National Center for Renal Health in Peru

Background:Hepatitis C(HCV)remains a serious public health problem in high-risk persons such as patients on chronic hemodialysis.We aimed to estimate the serological prevalence of HCV,the HCV viral load and genotype,and liver fibrosis stage among patients on chronic hemodialysis at the National Renal Health Center in Lima,Peru.Methods:From June 2019 to March 2021,all patients who received chronic hemodialysis were invited to participate.Subjects who provided written informed consent were enrolled.Patients with HCV-positive serology underwent determination of HCV viral load.Samples from subjects with detectable viral load,underwent determination of HCV genotype.Then,HCV infected subjects underwent determination of liver fibrosis using transitional elastography(Fibroscan 402):Metavir score:F0-F1:2.5-7.5 kPa,F2:7.6-9.5 Kpa,F3:9.6-12 Kpa,F4(Cirrhosis):12.1-75 Kpa.Results:Of the 303 subjects invited to participate,174(57.4%)subjects gave their written consent.Mean age was 52 years(range 22-91)and 116(66.6%)were male.HCV serology was positive in 35.1%of patients(61/174);however,the prevalence of positive serology with detectable viral load was 20.11%(35/174).Genotype 1a was the most prevalent(85%).The majority(83.6%)of subjects with detectable viral load had values lower than 800.000 IU/mL.Twenty-nine of those 35 subjects underwent elastography evaluation,and 13(44.8%)of them were found to have stage F2-F4 fibrosis.Conclusions:The prevalence of HCV at the largest reference center for hemodialysis in Lima remains high,with GT1a predominance,viral load usually below 800,000 IU/mL and significant liver fibrosis.