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

Abstract

Background/Aims: Hepatitis C virus (HCV) infection causes extrahepatic manifestations involving autoantibody production. This study aimed to elucidate the positivity rates of four autoantibodies (ANA, ASM, anti-LKM1, and AMA) in patients with chronic hepatitis C (CHC) before and after direct-acting antiviral (DAA) therapy compared to those in healthy controls. Methods: This study enrolled prospectively collected plasma samples from 201 CHC patients [median age, 62 years; 49.8% women] from eight hospitals before and after DAA therapy and 127 healthy individuals. Results: The ANA positivity at pretreatment was higher in CHC patients than in healthy controls (32.3% vs. 21.3%, p=0.030), which decreased at SVR (32.3% vs. 23.9%, p=0.009). Female sex and higher globulin levels were related to ANA positivity in the control and CHC patient groups, respectively. Patients with ANA positivity at pretreatment and at SVR (n=48) were older and had a higher proportion of advanced liver disease than ANA-negative patients at SVR (n=153). Conclusions: ANA positivity was observed in one-third of CHC patients at pretreatment, which was significantly higher than that in healthy controls, and decreased after SVR. CHC patients with ANA positivity after SVR were older and had more advanced liver disease than those with ANA negativity.