5 and cover slips. Autoantibody selleck chemical titer was determined by testing successive 2-fold dilutions of the serum up to 1/10,240. Analysis was performed by two independent expert observers (GDK & LEA) using an Olympus BX 50 microscope under 400�� magnification. Images were captured using a Carl Zeiss Axio-Imager M2 microscope. Categorical variables, such as sex, age group, and IIF patterns, were analyzed using the Chi-square test and the Fisher exact test when appropriate. Quantitative and semi-quantitative parameters with normal distribution were analyzed by ANOVA, and those with non-Gaussian distribution were analyzed using the Kruskal-Wallis test. All data were analyzed using SPSS for Windows 19.0. p values less than 0.05 were considered significant.
Results RR reactivity was readily recognized on Euroimmun and INOVA HEp-2 slides but either non-specific cytoplasmic dots or no relevant staining was observed with other commercial or homemade HEp-2 slides (Figure 1). In contrast, typical RR structures were readily apparent in HEp-2 cells treated with ribavirin (Figure 1E). Anti-RR reactivity was detected in sera of 57 of the 597 patients studied (9.5%), including 56 of the 397 with Hepatitis C (14.1%), 1 of 29 with Hepatitis B (3.4%), and none of 171 patients without any form of viral hepatitis. Thus, anti-RR reactivity was strongly associated with HCV (p<0.0001; Fisher's exact test between HCV and non-HCV controls). There was no significant difference in anti-RR reactivity between 51 of the 342 patients (14.9%) with HCV infection alone and 5 of the 55 patients (9.
1%) with HCV/HIV co-infection (p=0.301; Fisher’s exact test). Except for the single patient with Hepatitis B, no sample from patients with other hepatic diseases and systemic autoimmune diseases presented anti-RR reactivity. In contrast, other IIF-HEp-2 patterns were observed in variable proportions in all groups of patients. The nuclear fine speckled pattern was the dominant pattern in most patients, except for HCV patients in whom the RR and nuclear fine speckled patterns displayed a similar frequency (Table 1). Figure 1 IIF-HEp-2 rods and rings pattern in different slide brands. Table 1 Distribution of patients with HCV and other hepatic and non-hepatic diseases according to the presence of anti-RR and other IIF-HEp-2 patterns. Among HCV patients, anti-RR reactivity was clearly associated with treatment with ribavirin and interferon-��.
Treatment with interferon-�� and/or ribavirin had been administered to 176 HCV patients, while 166 HCV patients received no treatment. Anti-RR reactivity was detected in 51 treated patients (29%), but in none of the untreated patients (p<0.0001; Fisher's exact test). Cilengitide In contrast, other IIF-HEp-2 patterns were observed in 50 treated patients (28.4%) and in 44 untreated patients (26.5%) (p=0.598).
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