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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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., Lobritto, S. J., Mohan, P., Murray, K. F., Njoku, D. B., Rosenthal, P., Barton, B. A., Talor, M. V., Cheng, I., Schwarz, K., & 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