Prevalence and significance of anticardiolipin, anti‐β2 glycoprotein I and anti‐prothrombin antibodies in chronic hepatitis C
Prevalence and significance of anticardiolipin, anti‐β2 glycoprotein I and anti‐prothrombin antibodies in chronic hepatitis C
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慢性丙型肝炎中抗心磷脂、抗β2糖蛋白I和抗凝血酶原抗体的患病率和意义
DOI：
10.1046/j.1365-2141.1998.00722.x
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发表时间：
1998
影响因子：
6.5
通讯作者：
J. Zarski
中科院分区：
文献类型：
--
作者：
V. Leroy;J. Arvieux;M. Jacob;M. Maynard‐Muet;M. Baud;J. Zarski
抗磷脂抗体已被证明在慢性丙型肝炎，但其临床和致病意义仍然是难以捉摸的。我们前瞻性研究了115例（85例男性，平均年龄36.9岁）慢性丙型肝炎无肝硬化，并接受α-干扰素（α-IFN）治疗。抗磷脂测定包括抗心磷脂（ACA）、抗β2-糖蛋白I和IgG和IgM类抗凝血酶原抗体。在入组时，发现24例患者（21%）具有低至中度ACA水平（18例IgG，2例IgM和4例两种同种型），而115例年龄和性别匹配的对照受试者中仅4例（3.5% P = 0.001）。 α-IFN治疗6个月后ACA阳性率上升至31%（P =0.01）。 相反，在任一时间点，抗β2-糖蛋白I和抗凝血酶原抗体的患病率与对照组无显著差异。ACA的存在与抗核抗体相关（P = 0.0002），但与组织学活性、病毒负荷和对α-IFN的反应等参数无关，也与血栓形成或妊娠丢失史无关。 然而，观察到ACA阳性患者中轻度血小板减少症发生率较高的非显著趋势。我们得出结论，低滴度ACA阳性是慢性丙型肝炎患者的常见结果，特别是在α-IFN治疗后，但没有选择具有不同临床特征的类别。这些数据与缺乏相关抗β2GPI和抗凝血酶原抗体一致，不支持HCV感染在抗磷脂综合征发病机制中的作用。
Antiphospholipid antibodies have been demonstrated in chronic hepatitis C, but their clinical and pathogenetic significance remains elusive. We prospectively studied 115 patients (85 men, mean age 36.9 years) with chronic hepatitis C without cirrhosis and treated by α‐interferon (α‐IFN). Antiphospholipid determinations comprised anticardiolipin (ACA), anti‐β2‐glycoprotein I and anti‐prothrombin antibodies of the IgG and IgM classes. At entry, 24 patients (21%) were found to possess low to moderate ACA levels (18 IgG, two IgM and four both isotypes) compared with only 4/115 age‐ and sex‐matched control subjects (3.5% P = 0.001). ACA positivity rate increased to 31% (P = 0.01) after a 6‐month course of α‐IFN treatment. In contrast, the prevalence of anti‐β2‐glycoprotein I and anti‐prothrombin antibodies was not significantly different from controls at either time point. The presence of ACA correlated with that of antinuclear antibodies (P = 0.0002), but was not associated with parameters such as histological activity, viral burden and response to α‐IFN, nor with a history of thrombosis or pregnancy loss. However, a non‐significant trend of higher incidence of mild thrombocytopenia among ACA‐positive patients was observed. We conclude that low‐titre ACA positivity is a common finding in patients with chronic hepatitis C, especially following α‐IFN treatment, but does not select a category with different clinical features. These data are in keeping with the absence of associated anti‐β2GPI and anti‐prothrombin antibodies, and do not support a role for HCV infection in the pathogenesis of the antiphospholipid syndrome.