Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?

AIM: To evaluate the overlap of autoimmune hepatitis in hepatitis C virus (HCV)-infected patients with intense interface hepatitis.METHODS: Among 1759 patients with hepatitis C submitted to liver biopsy, 92 (5.2%) presented intense interface hepatitis. These patients were evaluated regarding the presence of antinuclear antibody (ANA), anti-smooth muscle antibody (SMA) and anti-liver/kidney microsomal antibody (LKM-1), levels of gamma-globulin and histological findings related to autoimmune hepatitis (plasma cell infiltrate and presence of rosettes).RESULTS: Among patients with hepatitis C and intense interface hepatitis there was a low prevalence of autoantibodies (ANA = 12%, SMA = 5%, LKM-1 = 0%) and the median gamma-globulin level was within the normal range. Typical histological findings of autoimmune disease were observed in only two cases (2%). After applying the score for diagnosis of autoimmune hepatitis, only one patient was classified with a definitive diagnosis of autoimmune hepatitis. Since overlap with autoimmune hepatitis was not the explanation for the intense necroinflammatory activity in patients with chronic hepatitis C we sought to identify the variables associated with this finding. the presence of intense interface hepatitis was associated with more advanced age, both at the time of infection and at the time of the biopsy, and higher prevalence of blood transfusion and alcohol abuse.CONCLUSION: Although possible, overlap with autoimmune hepatitis is a very rare association in HCV-infected patients with intense interface hepatitis, an unusual presentation which seems to be related to other host variables. (C) 2010 Baishideng. All rights reserved.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Div Gastroenterol, BR-04023900 São Paulo, BrazilUniv Fed Rio de Janeiro, Dept Internal Med, BR-21941913 Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, BrazilImmunol Grp, Fleury Med & Hlth, BR-04344903 São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, BrazilWeb of Scienc