title: Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C.
abstract: OBJECTIVE
  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).
authors: Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Jean P
authors: JP
authors: Molleston
authors: William
authors: W
authors: Mellman
authors: Michael R
authors: MR
authors: Narkewicz
authors: William F
authors: WF
authors: Balistreri
authors: Regino P
authors: RP
authors: Gonzalez-Peralta
authors: Maureen M
authors: MM
authors: Jonas
authors: Steven J
authors: SJ
authors: Lobritto
authors: Parvathi
authors: P
authors: Mohan
authors: Karen F
authors: KF
authors: Murray
authors: Dolores
authors: D
authors: Njoku
authors: Philip
authors: P
authors: Rosenthal
authors: Bruce A
authors: BA
authors: Barton
authors: Monica V
authors: MV
authors: Talor
authors: Irene
authors: I
authors: Cheng
authors: Kathleen B
authors: KB
authors: Schwarz
authors: Barbara A
authors: BA
authors: Haber
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis*; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D001323:Autoantibodies; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a