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Hepatitis C virus testing in primary biliary cirrhosis
E Bertolini1, P M Battezzati, P Zermiani
1First Department of Medicine, School of Medicine S. Paolo, University of Milan, Italy.
Insights
Hepatitis C virus (HCV) antibody positivity was found in 12% of primary biliary cirrhosis patients. This HCV status did not significantly impact patient survival or disease progression.
Area of Science:
- Hepatology
- Immunology
- Virology
Background:
- Primary biliary cirrhosis (PBC) is a chronic liver disease with autoimmune features.
- Hepatitis C virus (HCV) infection is a potential co-factor in liver disease progression.
Purpose of the Study:
- To investigate the prevalence of anti-HCV antibodies in patients with PBC.
- To determine if anti-HCV positivity affects the clinical course and life expectancy of PBC patients.
Main Methods:
- Retrospective analysis of 160 PBC patients diagnosed between 1980-1989.
- Testing for anti-HCV antibodies using C-100 ELISA and second-generation ELISA.
- Confirmation of antibody reactivity using C-100 RIBA and 4-RIBA.
- HCV RNA detection via polymerase chain reaction (PCR).
- Survival analysis to compare life expectancy between anti-HCV positive and negative groups.
Main Results:
- 12% of PBC patients were initially positive for anti-HCV (C-100 ELISA).
- Anti-HCV positivity remained stable over a median follow-up of 32 months, with increased detection by second-generation ELISA.
- HCV RNA was not detected in any tested samples, even those reactive by RIBA.
- No significant difference in life expectancy was observed between anti-HCV positive and negative PBC patients.
Conclusions:
- Anti-HCV positivity is present in a subset of PBC patients.
- HCV infection does not appear to influence the clinical presentation or prognosis of primary biliary cirrhosis.
- Further research may be needed to clarify the role of HCV in PBC pathogenesis.
Abstract:
We retrospectively investigated anti-HCV prevalence in a series of 160 consecutive patients with primary biliary cirrhosis who presented between 1980 and 1989. Of these, 19 (12%) were positive for anti-HCV by C-100 ELISA. Serum IgG levels were significantly higher in anti-HCV-positive patients and correlated to optical density values. A serum sample was again collected from all the patients from the same series who were seen in 1990 for follow-up, after a median period of 32 months. Anti-HCV positivity was found to be substantially unchanged in this subgroup of patients when the freshly drawn blood samples were retested with C-100 ELISA, while it increased from 10% to 17% when second generation ELISA was used. Three of the C-100 ELISA positive samples were C-100 RIBA reactive, and six of the second generation ELISA positive samples were 4-RIBA reactive. The HCV genome was not detected in any of the seven anti-HCV C-100 ELISA and second generation ELISA positive sera which were studied by polymerase chain reaction, including four cases confirmed by 4-RIBA. Life expectancy, as determined by survival analysis, did not differ significantly between anti-HCV-positive and -negative patients. These findings suggest that anti-HCV positivity does not influence the clinical presentation and course of primary biliary cirrhosis.