Low-titre auto-antibodies predict autoimmune disease during interferon-alpha treatment of chronic hepatitis C.
BACKGROUND
In this study, we determined whether low-titre auto-antibodies are a risk factor for the development of autoimmune disease during interferon-alpha (IFNalpha) therapy for chronic hepatitis C (CHC) infection.


METHODS
Eighty-three patients with circulating hepatitis C virus RNA and chronic viral hepatitis on liver biopsy, who had not received IFNalpha, were assessed for serum auto-antibodies (anti-nuclear antibodies (ANA), anti-smooth muscle antibodies, thyroid microsomal antibodies, thyroglobulin antibodies) and thyroid function tests.


RESULTS
Thirty-five patients had one or more pre-existing auto-antibody. The majority were low titre ANA. Seven of the 35 patients had clinical autoimmune disease or immune-mediated disorders, predominantly thyroid disease. Twenty patients with low titre auto-antibodies received treatment with IFNalpha and of these 20 patients, six patients developed adverse effects with a possible auto-immune basis. In comparison, only five of the 48 patients without auto-antibodies had immune-mediated disorders and no patient developed autoimmune complications during therapy with IFNalpha.


CONCLUSIONS
These results suggest that the presence of low-titre auto-antibodies may be a risk factor for the development of autoimmune dysfunction during IFNalpha therapy for chronic hepatitis C. Patients with no detectable auto-antibodies have a low risk for developing autoimmune complications during treatment with IFNalpha.
Bell
T M
TM
Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Bansal
A S
AS
Shorthouse
C
C
Sandford
N
N
Powell
E E
EE
D000328:Adult; D000368:Aged; D001168:Arthritis / Q000139:chemically induced / Q000150:complications; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology* / Q000628:therapy; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced / Q000150:complications; D007037:Hypothyroidism / Q000139:chemically induced / Q000150:complications; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011565:Psoriasis / Q000139:chemically induced / Q000150:complications
D001323:Autoantibodies; D016898:Interferon-alpha