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Published on: February 3, 2012
Autoantibody profile in individuals with chronic hepatitis C
Maíra Luciana Marconcini1, Leonardo Fayad, Maria Beatriz Cacese Shiozawa
1Núcleo de Estudos em Gastroenterologia e Hepatologia, Universidade Federal de Santa Catarina, Florianópolis, SC.
Insights
Autoantibodies, particularly non-organ-specific autoantibodies (NOSA), are common in chronic hepatitis C virus (HCV) infection. NOSA positivity correlates with a more severe biochemical and histological disease profile in HCV patients.
Area of Science:
- Hepatology
- Immunology
- Virology
Background:
- Autoantibodies frequently develop during chronic hepatitis C virus (HCV) infection.
- The influence of these autoantibodies on HCV's clinical and pathological presentation remains debated.
Purpose of the Study:
- To characterize autoantibodies in HCV patients.
- To evaluate the impact of autoantibodies on the biochemical and histological features of hepatitis C.
Main Methods:
- Cross-sectional analytical study of 66 HCV (RNA+) patients.
- Assessment of non-organ-specific autoantibodies (NOSA), thyroid autoantibodies, celiac disease autoantibodies, and cryoglobulins.
- Comparison of biochemical and histological markers between NOSA-positive and NOSA-negative patients.
Main Results:
- Non-organ-specific autoantibodies (NOSA) detected in 24% of patients.
- NOSA-positive patients showed higher alkaline phosphatase, lower platelet counts, and reduced prothrombin activity.
- Increased prevalence of significant fibrosis (E≥2) and a trend towards higher periportal activity (APP≥3) in NOSA-positive individuals.
Conclusions:
- HCV infection is associated with a high prevalence of autoantibodies.
- Non-organ-specific autoantibody (NOSA) positivity is linked to a more severe biochemical and histological profile in chronic hepatitis C.
Introduction:
Autoantibodies are often produced during infection with chronic hepatitis C virus (HCV), but it remains controversial whether they influence the biochemical profile and histological features of this disease. Therefore, this current study sought to describe these autoantibodies and evaluate their impact on the clinical and histological presentation of hepatitis C.
Methods:
This cross-sectional analytical study assessed patients with HCV (RNA+) from October 2011 to July 2012.
Results:
This study included 66 patients, with a mean age of 53.2±10.5 years. Of these patients, 60.6% were male, and 54.3% presented with genotype 1. Non-organ-specific autoantibodies (NOSA) were detected in 24% of the patients; of these, 7.6% were anti-mitochondrial antibodies (AMA+), 26.7% were anti-smooth muscle antibodies (SMA+) and 6.8% were liver kidney microsomal type 1 antibodies (LKM1+). With respect to the thyroid autoantibodies, 7.4% were anti-peroxidase (ATPO+) antibodies, and none were anti-thyroglobulin (ATG+) antibodies. Regarding celiac disease autoantibodies, 5.8% were endomysial antibodies (EMA+), and no transglutaminase (TTG+) antibodies were detected. Cryoglobulins were found in 2.1% of patients. When NOSA+ individuals were compared to patients without the presence of NOSAs, they exhibited higher median alkaline phosphatase (0.7 vs. 0.6 xULN; p=0.041), lower median platelet counts (141,500.0 vs. 180,500.0/mm 3 ; p=0.036), lower mean prothrombin activity (72.6±11.5% vs. 82.2±16.0%; p=0.012) and an increased prevalence of significant fibrosis (E≥2) (45.5% vs. 18.2%; p=0.012). There was also a tendency for a greater proportion of NOSA+ cases to have marked periportal activity (APP≥3) (44.5% vs. 15.6%; p=0.087).
Conclusions:
In addition to the high prevalence of autoantibodies associated with HCV infection, it was observed that NOSA positivity was associated with a more severe histological and biochemical profile of hepatitis C infection.
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