Gastric autoimmune disorders in patients with chronic hepatitis C before, during and after interferon-alpha therapy.
OBJECTIVE
To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of alpha-interferon (IFN) treatment on autoimmune gastritis.


METHODS
We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol. We evaluated: a) the baseline prevalence of autoimmune gastritis, b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3, 6 and 12 months), c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA), gastrin, anti-thyroid, and anti-non-organ-specific antibodies.


RESULTS
APCA positivity and 3-fold gastrin levels were detected in 3 (1.6 %) and 9 (5 %) patients, respectively, at baseline, in 25 (13 %) and 31 (16 %) patients at the end of treatment (both P<0.001, vs baseline), and in 7 (4 %) and 14 (7 %) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively, vs baseline; P=not significant vs end of treatment). The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P =0.0001), no relationship was found with other markers of autoimmunity.


CONCLUSIONS
In HCV patients, IFN frequently precipitates latent autoimmune gastritis, particularly in females. Following our 12-month protocol, the phenomenon generally regressed. Since APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.
Fabbri
Carlo
C
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
Jaboli
M Francesca
MF
Giovanelli
Silvia
S
Azzaroli
Francesco
F
Pezzoli
Alessandro
A
Accogli
Esterita
E
Liva
Stefania
S
Nigro
Giovanni
G
Miracolo
Anna
A
Festi
Davide
D
Colecchia
Antonio
A
Montagnani
Marco
M
Roda
Enrico
E
Mazzella
Giuseppe
G
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001327:Autoimmune Diseases / Q000453:epidemiology*; D005260:Female; D005755:Gastrins / Q000097:blood / Q000276:immunology; D005756:Gastritis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D010295:Parietal Cells, Gastric / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D013961:Thyroid Gland / Q000276:immunology; D016896:Treatment Outcome
D000998:Antiviral Agents; D005755:Gastrins; D016898:Interferon-alpha