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Prevalence of antirod and ring antibodies increased parallel to duration of HCV therapy

Patients with hepatitis C virus infection who underwent treatment with pegylated interferon and ribavirin showed increased levels of antirod and ring antibodies as therapy duration increased, according to study data.

“One-third of 88 patients with chronic hepatitis C treated with [PEG-IFN and ribavirin] were found to develop [antirod and rings] as consequence of antiviral therapy, at a frequency that was higher than previously reported in comparable populations,” the researchers wrote.

Serum samples from patients with HCV who were undergoing therapy with PEG-IFN and ribavirin were analyzed to determine whether antirod and ring antibodies developed during therapy due to the two drugs. Of the patients, 47 were men and 41 were women (aged 22-75 years). Therapy among the patients consisted of 180 mcg PEG-IFN alfa-2a (Pegasys, Roche) combined with 800 mg to 1,200 mg ribavirin (Copegus, Roche) per day for 24 or 28 weeks. Antirod and ring patterns were identified using indirect immunofluorescence on HEp-2 cells. None of the patients showed evidence of antibodies at baseline.

The amount of antirod and rings found among the patients increased as therapy duration increased; 9% at 12 weeks, 38% at 24 weeks and 53% at 48 weeks. The antibodies were more common among the patients with HCV genotype 1 and 4 infection compared with other genotypes (45% vs. 27%). Additionally, the median antirod and ring titer was higher among patients with HCV genotype 1 or 4 infection compared with other genotypes (P=.03).

Fifty-three patients achieved a sustained virologic response to therapy, 27 relapsed and eight were nonresponders. More antirod and ring antibodies were observed in the patients who relapsed compared with those who achieved SVR or were nonresponsive (56% vs. 30% and 12%; P=.0282).    

“Despite limitations of this study, we provide conclusive evidence of the relationship which exists between [antirod and ring] and HCV patients exposure to [PEG-IFN and ribavirin], whereas we tentatively offer a preliminary explanation for these novel cytoplasmic autoantibodies to reflect a drug-related injury of the HCV-infect hepatocytes,” the researchers concluded.

Disclosure: Relevant financial disclosures were not provided by researchers.