Viral hepatitis and anti-phospholipid antibodies positivity: A systematic review and meta-analysis

Background: Anti-phospholipid antibodies positivity is associated with several clinical conditions, including infectious diseases. Aims: We performed a meta-analysis evaluating the association of hepatitis B and C with anti-phospholipid antibody positivity and with anti-phospholipid antibody-related thrombotic complications. Methods: Studies evaluating the association of viral hepatitis with anti-cardiolipin, anti-beta(2) glycoprotein-I and lupus anticoagulant antibodies and anti-phospholipid antibody-related thrombotic events were systematically searched. Results: 20 studies (2319 cases, 1901 controls) were included. The analyses showed that viral hepatitis is associated with the presence of anti-cardiolipin and anti-beta(2) glycoprotein-I antibodies. The association with anticardiolipin antibodies was confirmed in both hepatitis B (OR 11.22, 95% CI: 6.68-18.84) and hepatitis C (OR 11.26, 95% CI: 6.82-18.59). Similarly, compared to controls, anti-beta(2) glycoprotein-I antibodies were found more frequently in hepatitis B (OR 14.07, 95% CI: 3.06-64.66) and hepatitis C (OR 5.64, 95% CI: 1.69-18.77). Moreover, 11 studies (257 cases, 1079 controls) showed a higher prevalence of venous and/or arterial thrombosis in patients with hepatitis and anti-cardiolipin antibody positivity compared hepatitis alone (OR 3.29, 95% CI: 1.79-6.07). This result was consistently confirmed in hepatitis C (OR 3.64, 95% CI: 1.78-7.46) but not in hepatitis B. Conclusions: Viral hepatitis is significantly associated with anti-phospholipid antibody positivity and with anti-phospholipid antibody-related thrombotic complications. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.