Analysis of serological characteristics in viral hepatitis patients with positive AMA-M2

Objective To explore the serological characteristics of viral hepatitis patients with positive anti- mitochondrial antibody( AMA)- M2 and its clinical implications. Methods Serum was collected from viral hepatitis patients who were admitted to Beijing You'an Hospital,Capital Medical University,from January 2011 to December 2013. Serum AMA- M2 was measured by ELISA. A total of 102 viral hepatitis patients with positive AMA- M2 were screened out,including 53 patients with chronic hepatitis B( CHB),27 patients with chronic hepatitis C( CHC),5 patients with hepatitis E( HE),9 patients with CHB accompanied by primary biliary cirrhosis( PBC),and 7 patients with CHC accompanied by PBC. We also collected serum from 60 PBC patients as controls. Patients were grouped by the clinical diagnosis and analyzed retrospectively considering their serological characteristics. Comparison of continuous data was made by one- way ANOVA. Results Level of serum AMA- M2 was low and medium in the CHB,CHC,and HE groups and was significantly lower than those of the PBC group and CHB / PBC and CHC / PBC groups( all P < 0. 0001). Serum ALT and AST in the HE group were significantly higher than that in the PBC group( P < 0. 01). Serum gamma- glutamyl transpeptidase( GGT) levels in the CHB and CHC groups were significantly lower than that in the PBC group( both P < 0. 001),but did not show significant difference when compared with the CHB / PBC or CHC / PBC group( P > 0. 05). Serum alkaline phosphatase( ALP) and Ig M in the CHB group were significantly lower than those in the PBC group( P< 0. 000 1). Serum ALP and Ig M in the CHC group were significantly lower than those in the PBC group and CHC / PBC group( all P <0. 05). Serum Ig M in the HE group was significantly lower that that in the PBC group( P < 0. 01). Serum C3 level in the CHB group was significantly lower than those in the PBC group and CHB / PBC group( both P < 0. 05). Conclusion AMA- M2 is not restricted to PBC patients alone,and medium or low level of AMA- M2 can be seen in patients with viral hepatitis,which is not an autoimmune disease. Other serological markers such as ALP,GGT,Ig M,and C3 are helpful in diagnosing and differentiating PBC.