Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C

Jean Molleston, William Mellman, Michael R. Narkewicz, William F. Balistreri, Regino P. Gonzalez-Peralta, Maureen M. Jonas, Steven J. Lobritto, Parvathi Mohan, Karen F. Murray, Dolores Njoku, Philip Rosenthal, Bruce A. Barton, Monica V. Talor, Irene Cheng, Kathleen B. Schwarz, Barbara A. Haber

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVES:: 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).

Original languageEnglish
Pages (from-to)304-310
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume56
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Chronic Hepatitis C
Autoantibodies
Autoimmune Diseases
Antibodies
Autoimmune Hepatitis
Glutamate Decarboxylase
Ribavirin
Hypothyroidism
Interferons
Therapeutics
Kidney
Iodide Peroxidase
Liver
Type 1 Diabetes Mellitus
Hepacivirus
Type 2 Diabetes Mellitus
Headache
Anti-Idiotypic Antibodies
Thyroid Gland
Insulin

Keywords

  • autoimmune
  • complications
  • diabetes
  • hypothyroid
  • pediatrics
  • therapy
  • viral hepatitis

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Molleston, J., Mellman, W., Narkewicz, M. R., Balistreri, W. F., Gonzalez-Peralta, R. P., Jonas, M. M., ... Haber, B. A. (2013). Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. Journal of Pediatric Gastroenterology and Nutrition, 56(3), 304-310. https://doi.org/10.1097/MPG.0b013e3182774cae

Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. / Molleston, Jean; Mellman, William; Narkewicz, Michael R.; Balistreri, William F.; Gonzalez-Peralta, Regino P.; Jonas, Maureen M.; Lobritto, Steven J.; Mohan, Parvathi; Murray, Karen F.; Njoku, Dolores; Rosenthal, Philip; Barton, Bruce A.; Talor, Monica V.; Cheng, Irene; Schwarz, Kathleen B.; Haber, Barbara A.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 56, No. 3, 03.2013, p. 304-310.

Research output: Contribution to journalArticle

Molleston, J, Mellman, W, Narkewicz, MR, Balistreri, WF, Gonzalez-Peralta, RP, Jonas, MM, Lobritto, SJ, Mohan, P, Murray, KF, Njoku, D, Rosenthal, P, Barton, BA, Talor, MV, Cheng, I, Schwarz, KB & Haber, BA 2013, 'Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C', Journal of Pediatric Gastroenterology and Nutrition, vol. 56, no. 3, pp. 304-310. https://doi.org/10.1097/MPG.0b013e3182774cae
Molleston, Jean ; Mellman, William ; Narkewicz, Michael R. ; Balistreri, William F. ; Gonzalez-Peralta, Regino P. ; Jonas, Maureen M. ; Lobritto, Steven J. ; Mohan, Parvathi ; Murray, Karen F. ; Njoku, Dolores ; Rosenthal, Philip ; Barton, Bruce A. ; Talor, Monica V. ; Cheng, Irene ; Schwarz, Kathleen B. ; Haber, Barbara A. / Autoantibodies and autoimmune disease during treatment of children with chronic hepatitis C. In: Journal of Pediatric Gastroenterology and Nutrition. 2013 ; Vol. 56, No. 3. pp. 304-310.
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AU - Jonas, Maureen M.

AU - Lobritto, Steven J.

AU - Mohan, Parvathi

AU - Murray, Karen F.

AU - Njoku, Dolores

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N2 - OBJECTIVES:: 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).

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