Anti-GOR is an
autoantibody found in hepatitis C virus (HCV)
infection. We have studied the specificity of this antibody for HCV
infection in various groups of autoimmune
liver diseases. Anti-HCV was detected by a second generation HCV
enzyme-linked
immunosorbent assay in 14 of 29 patients with liver-kidney-microsomal (LKM-1) -antibody-positive
autoimmune hepatitis type 2 and in all 6 control patients with HCV-
RNA-positive
chronic hepatitis C. Anti-HCV was not found in those with
antinuclear-antibody-positive
autoimmune hepatitis type 1 (10 patients), with soluble-liver-
protein-antibody-positive
autoimmune hepatitis type 3 (8), with
primary biliary cirrhosis (9), with
systemic lupus erythematosus (SLE) (10), or in healthy controls (13). Anti-GOR was detected in 11 of 14 patients with
autoimmune hepatitis type 2 who were all positive for anti-HCV but only in 1 of 15
LKM-1 patients who were negative for anti-HCV. We did not find anti-GOR in any other group of autoimmune
liver disease, SLE, or control sera, but this antibody was detected in 3 of 6 patients with
chronic hepatitis C.
Autoimmune hepatitis type 2 patients who were anti-GOR positive and anti-HCV positive were less likely to be female, were older (p less than 0.001), and had lower
LKM-1 antibody titres (p less than 0.001), lower disease activity, and responded less effectively to immuno- suppression than did those who were anti-HCV negative/anti-GOR negative. The findings show that anti-GOR reflects HCV-specific autoimmunity. HCV seems to induce autoimmunity to both GOR (an HCV-specific autoepitope) and
LKM-1 (an
epitope that is also recognised by
autoimmune hepatitis sera of a different cause). Anti-GOR and
LKM-1 antibodies contribute to a better differentiation of
chronic hepatitis, a finding that has therapeutic implications.