[Autoimmunity and HCV]

Since the discovery of HCV in 1989 and the availability of reliable tests to detect HCV infection, we are aware that a number of chronic hepatitis cases, previously considered as autoimmune, are closely related to HCV. This applies particularly to adults with autoimmune hepatitis type 2 (LKM1 positive): in the Mediterranean area the vast majority of such cases are indeed anti-HCV/HCV RNA positive. Different is the case of pediatric type 2 autoimmune hepatitis patients, whose disease is HCV-free and remains still "primary". In autoimmune hepatitis type 1 (anti-nuclear and anti-action antibody positive) HCV infection seems to be confined to patient with mild-moderate disease activity, while most of the severe cases are consistently HCV-free. Autoantibody testing is relevant in detecting autoimmune hepatitis within the cryptogenic subgroup and prior to interferon treatment of HCV-related chronic hepatitis.