Background and study aim:: Immunological disorders have been frequently described in the course of hepatitis C virus (HCV)–related chronic hepatitis. Our aim was to determine the prevalence of non-organ-specific autoantibodies (NOSAs) and evaluate its impact on the response to combined antiviral therapy in patients with chronic HCV genotype-4
Patients and methods:  A total of 134 adult patients with chronic HCV genotype-4 were investigated for the presence of serum Antinuclear antibody (ANA), anti–smooth muscle antibody (SMA), and anti liver/kidney microsomal antibody type 1 (LKM1). 109 out of 134 HCV patients were treated naive and received combined antiviral therapy (pegylated interferon–ribavirin). The presence of these autoantibodies was studied in relation to the patient's characteristics and the outcome of antiviral therapy.
Results :Thirty-six (26.9%) patients were positive for at least one autoantibody. Various autoantibodies were presented as follows: ANA in 29 (21.6%) patients, SMA in 9 (6.7%) and anti-LKM-1 in 2 (1.5%). In two patients, both ANA and anti-SMA were positive, and in other two cases both ANA anti-LKM-1 were positive. Female patients had a higher prevalence of positive autoantibodies (P=0.005). Chronic hepatitis C (CHC) patients with positive autoantibodies had higher serum ALT, AST and GGT levels. The rate of sustained virological response to combined antiviral therapy was similar between autoantibody-positive and -negative groups (46.9% vs. 53.2%).
Conclusion : Autoantibodies can be induced in the course of CHC. Autoantibody-positive CHC patients are older and have higher disease activity and severity. However, the presence of these autoantibodies did not influence the response to combination antiviral therapy.