Anti-C-reactive protein antibodies in chronic hepatitis C infection: correlation with severity and autoimmunity

The aim of this work was to detect circulating anti-C-reactive protein (CRP) antibodies in serum samples of patients with chronic hepatitis C virus (HCV) and to investigate a possible association with other autoimmune manifestations. A total of 94 patients with chronic HCV infections and 108 healthy controls were enrolled. All patients underwent a baseline evaluation: immunological assessment of cryoglobulin,antinuclear antibodies (ANA), rheumatoid factor (RF), anticardiolipin (aCLA), and anti-CRP antibodies. Patients with HCV underwent a liver biopsy scored according to the modified Knodell score. Anti-CRP antibodies were detected in 17% of HCV patients compared with 6.4% of the healthy controls (p < 0.025). When HCV patients positive for anti-CRP antibodies were compared with patients who were negative for anti-CRP antibodies, the prevalence of positive RF was significantly higher, 50% versus 17.9% (p < or = 0.05). Cryoglobulinemia was also significantly more frequent in patients who were positive for anti-CRP antibodies, 75% versus 32%, p < or = 0.01. ANA and aCLA did not differ significantly between the two groups. The presence of anti-CRP antibodies was associated with greater liver disease severity (histology activity index, 9 +/- 3.3 versus 6 +/- 2.9, p = 0.01). An increased prevalence of anti-CRP antibodies was manifested in HCV-infected patients. The presence of anti-CRP antibodies correlated with the presence RF, cryoglobulinemia, and severity of liver disease.