Autoantibodies in human immunodeficiency virusinfected patients with and without concurrent hepatitis C infection
Infections caused by human immunodeficiency virus (HIV) and hepatitis C virus (HCV), 2 blood-transmitted and frequently coinfecting agents, have been associated with autoantibody production (1-4), but there are few data concerning autoantibody production in patients with concurrent HIV and HCV infection (5-7). Even the presence of autoantibodies during HTV infection remains controversial (1,4,, and intcrcstingly, although autoimmune phenomena are highly prevalent during HCV infection (9-ll), there are no published reports on the possibility of concomitant HCV and HIV infection as a potential confounder when studying autoimmune phenomena in HIV-infccted patients.
We recently conducted a study in which HIV-infected patients were stratified into 2 subgroups based on the presence or absence of HCV infection. Paticnts with opportunistic infections, rheumatic diseases, or serum reactivity for syphilis, hepatitis B: or Typanosoma cnizi were excluded. Criteria for diagnosis of HCV infection wcre the detection of anti-HCV antibodies by a second-generation enzyme-linked immunoassay (ELISA) (UBI HCV EIA 4.0; Beijing United Biomedical, Beijing, China) confirmed by recombinant immunoblot (LIA TEK HCVTII; Organon Teknika, Dublin, Ireland) plus persistcntly clevated serum levels of alanine aminotransferase in the absence of any other cause of hepatic involvement. All of the HCV-infected paticnts had a history of drug abuse.
Prior to initiation of any treatmcnt, patients were tested for CD4+ cell count and for levels of antinuclear antibodies (ANA), anti-native-DNA antibodies (anti-nDNA), rheumatoid factor (RF) (by latex agglutination and Rose-Waaler testing), antimicrosomal antibodies, antithyroglobulin antibodies (ATG), C3 and C4 complemcnt components, and HIV p24 antigenemia.
Antimicrosomal antibodies, ATG, ANA, and anti-nDNA were measured in serial serum dilutions, using indirect immunofluorescence and latex gelatin particle agglutination for antimicrosoinal antibodies and ATG (Inmunofluor ATAm; Biocientifica, Buenos Aires, Argentina, and Sera-Tek thyroglobulin and Sera-Tek microsomal; Fujircbio, Tokyo, Japan) and indirect immunofluorescence with rat liver slides (Inmunofluor-Cortes de Higado de Rata, ANAs; Biocientifica)