Triggering of acute alcoholic hepatitis by alpha-interferon therapy.
OBJECTIVE
Alcohol may induce autoimmunity by recognition of acetaldehyde-modified proteins which may be implicated in the pathogenicity of acute alcoholic hepatitis. We report here the potential role of alpha-interferon, a potent inducer of the autoimmunity process, in inducing alcoholic hepatitis.


METHODS
We analyzed clinical, biological, virological and histological features in two cases where alpha-interferon treatment for HCV-related hepatitis led to a marked increase in aminotransferase activities.


RESULTS
alpha-interferon as treatment of HCV-related hepatitis seemed to exacerbate acute alcoholic hepatitis despite moderate alcohol consumption. In Case 1, moderate daily alcohol intake of 40 g during therapy led to biopsy-proven acute alcoholic hepatitis, while the same consumption before therapy did not. In Case 2, before treatment, the liver biopsy showed mild acute alcoholic hepatitis; aminotransferases increased during alpha-interferon therapy, although no increase in alcohol intake was observed.


CONCLUSIONS
alpha-interferon therapy by its immunomodulatory properties could be implicated in alteration of the course of acute alcoholic hepatitis. These observations emphasize that the decision to treat with alpha-interferon when there is even moderate alcohol consumption should be carefully weighted in HCV-infected patients.
Zylberberg
H
H
Unité d'Hépatologie, Hôpital Necker, Paris, France.
Fontaine
H
H
Thépot
V
V
Nalpas
B
B
Bréchot
C
C
Pol
S
S
D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D018450:Disease Progression; D019698:Hepatitis C, Chronic / Q000150:complications / Q000628:therapy*; D006519:Hepatitis, Alcoholic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D016898:Interferon-alpha; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase