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Sir—We read with interest the article by Muratori et al. [1], who evaluated the prevalence and clinical significance of non–organ-specific antibodies (NOSAs) among 47 children with hepatitis C virus (HCV) infection and 67 pediatric control subjects (42 children with hepatitis B virus infection and 25 healthy children). They found the following: (1) seropositivity for NOSAs in 34% of chronically infected patients, (2) HCV loads significantly higher in NOSA-seronegative children than in NOSA-seropositive children, and (3) achievement of long-term response after IFN treatment in 55% of the NOSA-seronegative children but in only 18% of the NOSA-seropositive children—a finding interpreted as showing that NOSA seropositivity hinders the therapeutic effect of IFN treatment.

We would like to make some comments. A study from our own laboratory [2] reported a much higher prevalence of NOSA seropositivity among HCV-infected children, with an overall prevalence of seropositivity of 65% (33 of 51 patients), compared with that of 34% (16 of 47 patients) in the study by Muratori et al. [1]. The 2 studies had a comparable number of HCV-infected patients of Italian origin (51 vs. 47), had similar male : female ratios (1 vs. 1.3), and evaluated sequential serum samples. Muratori et al. [1], making reference to our findings, suggest that the discrepancy in prevalence of NOSA seropositivity between the 2 studies is mainly due to a higher percentage of patients positive for anti–smooth muscle antibody in our series than in theirs (25 [49%] of 51 patients vs. 8 [17%] of 47) and that this discrepancy is possibly a reflection of differences in methodology (e.g., differences in the autoantibody substrates and antisera used).

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