CXCL9 and CXCL13 as Predictive Biomarkers for Autoimmune-like Phenotype in Chronic Hepatitis C: Evidence for Viral-Induced Autoimmune Hepatitis Transition

Abstract

BackgroundChemokines CXCL9 and CXCL13 regulate immune cell trafficking, and they may serve as predictive markers for autoimmune-like transformation in chronic viral hepatitis. ObjectiveAssess serum CXCL9 and CXCL13 level as biomarker in chronic HBV, HCV, and control established Autoimmune hepatitis (AIH). Methods180 participants were enrolled: 45 patients with Chronic hepatitis B virus (HBV), 45 patients with Chronic hepatitis C virus (HCV), 45 patients with confirmed autoimmune hepatitis and 45 healthy controls. Serum CXCL9 and CXCL13 concentrations were quantified using ELISA. Statistical analyses included Kruskal-Wallis tests, post hoc comparisons, and Spearman correlations. ResultsCXCL13 levels showed progressive elevation: controls (12.45 {+/-} 3.21 ng/L) < HBV (32.43 {+/-} 18.52 ng/L) < HCV (66.14 {+/-} 34.78 ng/L) {approx} AIH (68.92 {+/-} 41.23 ng/L) (p < 0.001). Similarly, CXCL9 demonstrated: controls (8.73 {+/-} 2.94 ng/L) < HBV (27.57 {+/-} 19.84 ng/L) < HCV (57.57 {+/-} 31.45 ng/L) {approx} AIH (61.28 {+/-} 38.67 ng/L) (p < 0.001). Strong positive correlations between CXCL9 and CXCL13 were observed in HCV (r = 0.518, p = 0.001) and AIH groups (r = 0.623, p < 0.001), but not in HBV or controls. ConclusionHCV infection demonstrates chemokine profiles indistinguishable from established AIH, supporting the hypothesis that chronic HCV may trigger autoimmune hepatitis development. CXCL9 and CXCL13 are potential predictive biomarkers for viral-induced autoimmune liver disease transition.