High prevalence of antinuclear antibodies in hepatitis C related hepatocellular carcinoma.

In chronic hepatitis C (CHC), the virus may induce autoimmune responses via autoantibodies production, including antinuclear antibodies (ANA). Former studies reported great ANA predisposition in CHC and these ANAs may be related to worse prognosis including hepatocellular carcinoma (HCC). We aimed to evaluate the association between ANA incidence and CHC-related HCC development and to evaluate these molecules effect on HCC severity including tumor size and advanced stages. Results revealed that ANA seropositivity was associated with disease severity. HCC patients (54%, OR = 9.7) were associated with ANA positivity more than liver cirrhosis (24.5%) and fibrosis (10.8%). ANA positivity was significantly high in patients with severe tumor features including macrovascular invasion (61.9%; OR = 8.1), large size (68.2%; OR = 2.4), Child C (83.3%; OR = 8.1), BCLC end stage (83.3%; OR = 8.6) and advanced CLIP stage (80.9%; OR = 7.9). ANA positivity were significantly (p < 0.05) correlated with some estimated liver fibrosis related biomarkers including EMA (r = 0.206), fibronectin (r = 0.273), cytokeratin-1 (r = 0.365) and collagen III (r = 0.324). In conclusion, our observation of increased ANA+ serum samples among CHC-related HCC might suggest the oncogenic role of ANA in such patients. Also, clinicians need to appreciate value of ANA testing among HCC patients as these molecules were associated with tumor severity and worse outcomes.