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Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C Molleston JP; Mellman W; Narkewicz MR; Balistreri WF; Gonzalez-Peralta RP; Jonas MM; Lobritto SJ; Mohan P; Murray KF; Njoku D; Rosenthal P; Barton BA; Talor MV; Cheng I; Schwarz KB; Haber BAJ Pediatr Gastroenterol Nutr 2013[Mar]; 56 (3): 304-10OBJECTIVES: Autoantibodies were studied in a well-characterized cohort of children with chronic hepatitis C during treatment with pegylated interferon and ribavirin to assess the relation with treatment and development of autoimmune disease. METHODS: : A total of 114 children (5-17 years), screened for the presence of high-titer autoantibodies, were randomized to pegylated interferon with or without ribavirin. Anti-nuclear, anti-liver-kidney-microsomal, anti-thyroglobulin, anti-thyroid peroxidase, insulin, anti-glutamic acid decarboxylase (GAD) antibodies were measured after trial completion using frozen sera. RESULTS: At baseline, 19% had autoantibodies: anti-nuclear antibodies (8%), anti-liver-kidney-microsomal antibodies (4%), and glutamic acid decarboxylase antibodies (4%). At 24 and 72 weeks (24 weeks after treatment completion), 23% and 26% had autoantibodies (P=0.50, 0.48 compared with baseline). One child developed diabetes and 2 hypothyroidism during treatment; none developed autoimmune hepatitis. At 24 weeks, the incidence of flu-like symptoms, gastrointestinal symptoms, and headaches was 42%, 8% and 19% in those with autoantibodies versus 52%, 17%, and 26% in those without (P=0.18, 0.36, and 0.20, respectively). In children with negative hepatitis C virus polymerase chain reaction at 24 weeks, there was no difference in the rate of early virologic response/sustained virologic response, respectively, in those with autoantibodies 76%/69% vs 58%/65% in those without (P=0.48). CONCLUSIONS: Despite screening, we found autoantibodies commonly at baseline, during treatment for chronic hepatitis C and after. The presence of antibodies did not correlate with viral response, adverse effects, or autoimmune hepatitis. Neither screening nor archived samples assayed for thyroid and diabetes-related antibodies identified the 3 subjects who developed overt autoimmune disease, diabetes (1), and hypothyroidism (2).|Adolescent[MESH]|Antiviral Agents/*adverse effects/therapeutic use[MESH]|Autoantibodies/*analysis[MESH]|Autoimmune Diseases/*chemically induced/diagnosis/epidemiology[MESH]|Child[MESH]|Child, Preschool[MESH]|Cohort Studies[MESH]|Drug Resistance, Multiple, Viral[MESH]|Drug Therapy, Combination/adverse effects[MESH]|Female[MESH]|Hepacivirus/drug effects[MESH]|Hepatitis C, Chronic/blood/*drug therapy/*immunology/virology[MESH]|Humans[MESH]|Incidence[MESH]|Interferon-alpha/adverse effects/therapeutic use[MESH]|Longitudinal Studies[MESH]|Male[MESH]|Polyethylene Glycols/adverse effects/therapeutic use[MESH]|Predictive Value of Tests[MESH]|Recombinant Proteins/adverse effects/therapeutic use[MESH]|Ribavirin/*adverse effects/therapeutic use[MESH]|United States/epidemiology[MESH] |
