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AC-23 - RODS and RINGS
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Most commonly found in HCV patients who have been treated with pegylated interferon-?/ribavirin combination therapy, but autoantibodies revealing the AC-23 patterns were undetected prior to treatment; as the use of interferon-?/ribavirin in HCV treatment is decreasing, the frequency and clinical associations of the AC-23 pattern may change
Specific immunoassays to detect autoantibodies directed to specific Rods and Rings antigens, for instance IMPDH2, are not commercially available
Presence of the AC-23 pattern depends on the HEp-2 cell substrate.
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HCV patients positive for the AC-23 pattern have been reported to have disease that is more resistant to therapy, but this is not confirmed in other cohorts
The AC-23 pattern has also been reported rarely in individuals without HCV infection, including SLE patients and patients under treatment with mycophenolic acid, azathioprine, methotrexate or acyclovir, as well as with lower titers in the general population