2021 The European Congress of Clinical Microbiology and Infectious Diseases (31st ECCMID), Amstetten, Avusturya, 9 - 12 Temmuz 2021
Background Rods and Rings (RR) is a distinct rod and ring structures in the cytoplasm of
interphase cells (Figure 1.). Anti-rods and rings (AC-23, ANA IIF Hep-2 Pattern) antibodies has
been associated with Hepatitis C patients with a-interferon/ribavirin (IFN/RBV) combination
therapy. Few studies demonstrate anti-RR appearance in healthy individuals and in other health
conditions, such as rheumatoid arthritis, systemic lupus erythematosus and idiopathic
thrombocytopenia. In this study, the impact of RR pattern as a biomarker in HCV positive and
non-HCV patients were investigated.
Methods Medical records of patients admitted to Kocaeli University Hospital, between 2015 to
2021, with anti-RR were enrolled. ANA test was performed using Hep-20-10 kit analysis
(Euroimmun, Luebeck, Germany). HCV was diagnosed by detecting anti-HCV antibodies with
Architect i2000 (Abbott, USA). Standard statistical techniques including chi‐square tests for
contingency tables for univariable data were performed. Factors with a P‐value ≤0.25 in
univariable analysis were entered into a multivariable logistic regression model. P-value <0.05
values were considered significant.
Results Of the 33 anti-RR positive patients, 63.6% (21/33) were female. Mean age of the
patients was 52.7±15.1 (median:53, range:23-77). The rate of patients with titre >1:100 was
81.8% (27/33). Anti-HCV positivity was found in 33.3% (11/33) patients. Of the 11 HCV positive
patients, 81.8% (9/11) were female. Mean age of HCV patients was 62.5±14.7 (median: 66,
range: 23-77). Of the 22 non-HCV patients, 54.5% (12/22) were female. Mean age of non-HCV
patients was 47.8±12.9 (median: 45.5, range: 29-75). Five of non-HCV patients had systemic
rheumatic disease and other 5 had arthralgia without having a definite diagnosis (Table 1). As
shown in Table 2, age was significantly correlating with HCV in anti-RR positive patients (OD:
21.43, 95%CI: 3.19-434.8, p=0.007). In multivariable analysis, age was retained its significance,
gender was in-significantly correlated (OD: 3.75, 95%CI: 0.54-35.60, p=0.199) with HCV
positivity in study population.
Conclusions Since HCV correlates with ages in anti-RR positive patients, its use in age related
conditions may considered as a biomarker. In the future, it should be investigated that RR
positivity may be an important biomarker affecting the prognosis not only in HCV patients but
also in other diseases.