FROM A POSITIVE AUTOANTIBODY TO AUTOIMMUNE DISEASE: WHAT DOES THE EVIDENCE SHOW FOLLOWING VIRAL INFECTIONS?
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6579Keywords:
Autoantibodies, Viral Infection, Seroconversion, Longitudinal Studies, Autoimmune Disease, Diagnostic MisclassificationAbstract
Autoantibodies are commonly detected during or shortly after viral illness, sometimes in patients whose presentation already resembles a systemic or organ-specific autoimmune disorder. The difficulty is that the laboratory finding often arrives before the clinical meaning of that finding is clear. In acute parvovirus B19 and hepatitis E, ANA, RF or autoimmune liver serology may accompany the infection and then recede as the illness resolves. SARS-CoV-2 cohorts that include pre-infection samples show that genuine seroconversion can occur, but they also expose a separate problem: a newly detectable or persistent autoantibody is not the same endpoint as clinically defined autoimmune disease. HCV-associated cryoglobulinaemic vasculitis is different because infection, immune-complex formation and organ disease belong to the same pathogenic process. Across the other viral settings, interpretation is limited by referral bias, incomplete follow-up, assay heterogeneity and the frequent use of serological rather than clinical endpoints. Taken together, the recent literature supports post-viral autoreactivity far more consistently than it supports frequent progression to a new autoimmune disease. Diagnostic weight increases when the antibody is disease-concordant, persists beyond the acute infection and accompanies an objective phenotype that the infection no longer adequately explains.
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Copyright (c) 2026 Anna Gwóźdź-Broczkowska, Agata Kotłowska, Julia Lenkiewicz, Aleksandra Izabela Masłowska, Wiktoria Napiórkowska, Gabriela Luba, Marcin Trzciński, Oliwia Lenkiewicz
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