CYCLOSPORINE-A IN THE TREATMENT OF AUTOIMMUNE CHRONIC ACTIVE HEPATITIS OCCURRING WITH OR WITHOUT CIRCULATING ANTIBODIES AGAINST HEPATITIS-C VIRUS

The aim of this study was to evaluate the efficacy of cyclosporin A (CyA) in the treatment of autoimmune chronic active hepatitis (CAH) occurring either with or without circulating anti-hepatitis C virus (HCV) antibodies. The study population consisted of eleven patients with histological finding of CAH associated with high titres of anti-nuclear antibodies and hypergammaglobulinaemia. Eight patients were found to be also positive for circulating antibodies against hepatitis C virus (HCV). CyA was administered orally for 1 year at a dose of 5 mg/kg/die. The results demonstrate that CyA is effective in inducing a persistent biochemical and histological improvement in those patients negative for anti-HCV antibodies. On the other hand, in only one anti-HCV-positive patient was a sustained decrease of ALT level observed, and no histological change was found at the end of treatment in any of the anti-HCV-positive patients. These results suggest that CyA therapy might be indicated only for those autoimmune CAH patients without evidence of HCV infection.