title: Prevalence and clinical features of celiac disease in patients with hepatitis B virus infection in Southern Brazil.
abstract: BACKGROUND
  Celiac disease is an autoimmune disorder that involves gluten intolerance and can be triggered by environmental factors including hepatitis B virus (HBV) infection. This study aimed to describe the prevalence of celiac disease in individuals with HBV infection and to describe the clinical and laboratory characteristics of celiac disease associated with HBV.
  
  
  METHODS
  This cross-sectional study included 50 hepatitis B patients tested for IgA anti-endomysial antibodies (EMAs) and tissue anti-transglutaminase (TTG) between August 2011 and September 2012.
  
  
  RESULTS
  Fifty patients were included with a mean age of 46.0 ± 12.6 (46.0) years; 46% were female and 13% were HBeAg+. Six patients had positive serology for celiac disease, four were EMA+, and five were TTG+. When individuals with positive serology for celiac disease were compared to those with negative serology, they demonstrated a higher prevalence of abdominal pain (100% vs. 33.3%, p = 0.008), lower median creatinine (0.7 mg/dL vs. 0.9 mg/dL, p = 0.007) and lower mean albumin (3.6 ± 0.4 g/L vs. 3.9 ± 0.3g/L, p = 0.022). All individuals with positive serology for celiac disease underwent upper digestive endoscopy, and three of the patients exhibited a macroscopic pattern suggestive of celiac disease. Histologically, five patients demonstrated an intra-epithelial lymphocytic infiltrate level > 30%, and four patients showed villous atrophy associated with crypt hyperplasia on duodenal biopsy.
  
  
  CONCLUSIONS
  An increased prevalence of celiac disease was observed among hepatitis B patients. These patients were symptomatic and had significant laboratory abnormalities. These results indicate that active screening for celiac disease among HBV-infected adults is warranted.
authors: Núcleo de Estudos em Gastroenterologia e Hepatologia, Universidade Federal de Santa Catarina, Florianópolis, SC.
authors: Angélica Luciana
authors: AL
authors: Nau
authors: Leonardo
authors: L
authors: Fayad
authors: César
authors: C
authors: Lazzarotto
authors: Maria Beatriz Cacese
authors: MB
authors: Shiozawa
authors: Esther Buzaglo
authors: EB
authors: Dantas-Corrêa
authors: Leonardo de Lucca
authors: Lde L
authors: Schiavon
authors: Janaína Luz
authors: JL
authors: Narciso-Schiavon
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001938:Brazil / Q000453:epidemiology; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006515:Hepatitis B virus / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D011503:Transglutaminases