[Hepatitis C virus and autoimmune hepatitis: coincidence or causal relationship?]

HCV has been implicated in a variety of immune disorders as Sjogren's Syndrome, thyroiditis, glomerulonephritis, panarteritis nodosa and AIH. Soon after its discovery HCV has been causative associated with AIH due to a high incidence of antibodies against the virus tested by first generation assays. However applying more specific systems and by direct demonstration of the HCV RNA we have found only 2% of patients with confirmed AIH to harbour the virus. About 19% of patients with virus Hepatitis C may present with autoantibodies in the serum as RNA, SNA and only 2% have antibodies against LKM Type 1. Liver biopsies from patients with chronic Hepatitis C and autoantibodies display features typical for chronic hepatitis C as described in the literature and not those of the autoimmune type. Furthermore immunohistological findings show a predominance of CD8 lymphocytes and only a weak expression of ASGPR, parameters that are easily found in autoimmune hepatitis. On the basis of serological, histopathological and immunohistological studies it seems very unlikely that HCV can be regarded as a causative agent for the induction of autoimmune Hepatitis.