[Autoantibodies against islet cell antigens and type 1 diabetes after treatment with interferon-alpha].
OBJECTIVE
The aim of this study was to study the appearance of autoantibodies against islet cells and the development of type 1 diabetes in patients with chronic hepatitis C during interferon treatment.


METHODS
74 patients (24 women, 50 men, mean age: 46 years) with HCV infection were treated with interferon, ribavirin and amantadin versus placebo, after they had failed to previous interferon therapy in a prospective, randomised trial. At the end of treatment period anti-islet cell autoantibodies (anti-GAD, anti IA-2), anti-insulin antibodies, TSH, anti-thyroid autoantibodies (TPO, thyreoglobulin, TSH-receptor antibodies) were measured.


RESULTS
In two patients, GAD autoantibodies were found, but both patients were negative for IA-2 and insulin antibodies. One of the patients developed type 1 diabetes five months after start of treatment. In this patient, the anti-GAD titer was initial 0 U/ml (normal: < 1.2). The titer raised to 52,2 U/ml after the interferon monotherapy. During the second interferon treatment (in combination) the titer raised from initial 41,1 U/ml to 59,6 U/ml. The anti-GAD titer of the second patient was 0 U/ml before treatment and raised to 1,7 U/ml. This patient did not develop a type 1 diabetes.


CONCLUSIONS
Type 1 diabetes is a rare but serious complication of interferon therapy. Repetitive treatment seems to facilitate this complication. Screening for islet antibodies before a second therapy could be useful.
Schories
M
M
Abteilung Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und Infektiologie, Albert-Ludwigs-Universität Freiburg. schories@med1.ukl.uni-freiburg.de
Peters
T
T
Rasenack
J
J
Reincke
M
M
D000547:Amantadine / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced / Q000188:drug therapy* / Q000276:immunology*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D017211:Treatment Failure
D000998:Antiviral Agents; D001323:Autoantibodies; D016898:Interferon-alpha; C006606:anti-thyroglobulin; C024211:islet cell antibody; D012254:Ribavirin; D000547:Amantadine