Serum markers of infections in patients with primary biliary cirrhosis: Evidence of infection burden

Yinon Shapira, Nancy Agmon-Levin, Yves Renaudineau, Bat Sheva Porat-Katz, Ori Barzilai, Maya Ram, Pierre Youinou, Yehuda Shoenfeld

Research output: Contribution to journalArticlepeer-review


Background: Currently not much is known regarding the environmental factors involved in primary biliary cirrhosis (PBC). It is even more unclear which factors may determine the subgroup (i.e., AMA status) of patients with PBC. We thus tested AMA + and AMA. - PBC patients' sera for antibodies (Abs) against multiple infectious agents. Methods: Sera from 69 patients with PBC (49 AMA + and 20 AMA. -) and 100 matched controls were screened for IgG-Abs against Toxoplasma gondii, Helicobacter pylori, Epstein-Barr virus (EBV), cytomegalovirus (CMV), hepatitis B, and hepatitis C utilizing the BioPlex 2200 and ELISA kits (Bio-Rad Laboratories, USA). Results: The prevalence of four anti-infectious agents Abs was significantly elevated among PBC patients when compared with controls, namely anti-T. gondii (ATxA; 71% vs. 40%, p< 0.0001), EBV early antigen (EA; 44% vs. 12%, p< 0.0001), H. pylori (54% vs. 31%, p< 0.01), and CMV (90% vs. 75%, p< 0.05) Abs, respectively. The co-occurrence of these four anti-infectious agents Abs was highly common in PBC, whereas this infection burden was rare in healthy subjects (20% vs. 3% respectively, p< 0.0001). Furthermore, specific infections interactions possibly increasing PBC risk were noted as well. Seropositivity of ATxA was inversely associated with cirrhosis among PBC patients (p< 0.05). Finally, no differences were observed between AMA. - sera and their AMA + counterparts with regard to seroprevalence of any of the investigated infectious agents. Conclusions: We note the association of ATxA and PBC, with the possibility of a milder disease manifestation. We also suggest that multiple exposures to infectious agents may contribute to PBC risk.

Original languageEnglish
Pages (from-to)386-390
Number of pages5
JournalExperimental and Molecular Pathology
Issue number3
StatePublished - Dec 2012


  • Cytomegalovirus
  • Epstein-Barr virus
  • Helicobacter pylori
  • Infection
  • PBC
  • Toxoplasmosis


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