Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C

Jean P. Molleston, William Mellman, Michael R. Narkewicz, William F. Balistreri, Regino P. Gonzalez-Peralta, Maureen M. Jonas, Steven J. Lobritto, Parvathi Mohan, Karen F. Murray, Dolores B Njoku, Philip Rosenthal, Bruce A. Barton, Monica V. Talor, Irene Cheng, Kathleen Schwarz, Barbara A. Haber

Research output: Contribution to journalArticle

Abstract

OBJECTIVES:: 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).

Original languageEnglish (US)
Pages (from-to)304-310
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume56
Issue number3
DOIs
StatePublished - Mar 2013

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Chronic Hepatitis C
Autoantibodies
Autoimmune Diseases
Antibodies
Autoimmune Hepatitis
Glutamate Decarboxylase
Ribavirin
Hypothyroidism
Interferons
Therapeutics
Kidney
Iodide Peroxidase
Liver
Type 1 Diabetes Mellitus
Hepacivirus
Type 2 Diabetes Mellitus
Headache
Anti-Idiotypic Antibodies
Thyroid Gland
Insulin

Keywords

  • autoimmune
  • complications
  • diabetes
  • hypothyroid
  • pediatrics
  • therapy
  • viral hepatitis

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Molleston, J. P., Mellman, W., Narkewicz, M. R., Balistreri, W. F., Gonzalez-Peralta, R. P., Jonas, M. M., ... Haber, B. A. (2013). Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. Journal of Pediatric Gastroenterology and Nutrition, 56(3), 304-310. https://doi.org/10.1097/MPG.0b013e3182774cae

Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. / Molleston, Jean P.; Mellman, William; Narkewicz, Michael R.; Balistreri, William F.; Gonzalez-Peralta, Regino P.; Jonas, Maureen M.; Lobritto, Steven J.; Mohan, Parvathi; Murray, Karen F.; Njoku, Dolores B; Rosenthal, Philip; Barton, Bruce A.; Talor, Monica V.; Cheng, Irene; Schwarz, Kathleen; Haber, Barbara A.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 56, No. 3, 03.2013, p. 304-310.

Research output: Contribution to journalArticle

Molleston, JP, Mellman, W, Narkewicz, MR, Balistreri, WF, Gonzalez-Peralta, RP, Jonas, MM, Lobritto, SJ, Mohan, P, Murray, KF, Njoku, DB, Rosenthal, P, Barton, BA, Talor, MV, Cheng, I, Schwarz, K & Haber, BA 2013, 'Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C', Journal of Pediatric Gastroenterology and Nutrition, vol. 56, no. 3, pp. 304-310. https://doi.org/10.1097/MPG.0b013e3182774cae
Molleston, Jean P. ; Mellman, William ; Narkewicz, Michael R. ; Balistreri, William F. ; Gonzalez-Peralta, Regino P. ; Jonas, Maureen M. ; Lobritto, Steven J. ; Mohan, Parvathi ; Murray, Karen F. ; Njoku, Dolores B ; Rosenthal, Philip ; Barton, Bruce A. ; Talor, Monica V. ; Cheng, Irene ; Schwarz, Kathleen ; Haber, Barbara A. / Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. In: Journal of Pediatric Gastroenterology and Nutrition. 2013 ; Vol. 56, No. 3. pp. 304-310.
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AU - Mellman, William

AU - Narkewicz, Michael R.

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AU - Gonzalez-Peralta, Regino P.

AU - Jonas, Maureen M.

AU - Lobritto, Steven J.

AU - Mohan, Parvathi

AU - Murray, Karen F.

AU - Njoku, Dolores B

AU - Rosenthal, Philip

AU - Barton, Bruce A.

AU - Talor, Monica V.

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AU - Schwarz, Kathleen

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N2 - OBJECTIVES:: 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).

AB - OBJECTIVES:: 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).

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