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

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    Authors
    Molleston, Jean P.
    Mellman, William
    Narkewicz, Michael R.
    Balistreri, William F.
    Gonzalez-Peralta, Regino P.
    Jonas, Maureen M.
    Lobritto, Steven J.
    Mohan, Parvathi S.
    Murray, Karen F.
    Njoku, Dolores
    Rosenthal, Philip
    Barton, Bruce A.
    Talor, Monica V.
    Cheng, Irene
    Schwarz, Kathleen B.
    Haber, Barbara A.
    Show allShow less
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2013-02-27
    Keywords
    Clinical Epidemiology
    Hepatology
    Immune System Diseases
    Pediatrics
    Pharmacy and Pharmaceutical Sciences
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1097/MPG.0b013e3182774cae
    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).
    Source
    J Pediatr Gastroenterol Nutr. 2013 Mar;56(3):304-10. doi: 10.1097/MPG.0b013e3182774cae. Link to article on publisher's site
    DOI
    10.1097/MPG.0b013e3182774cae
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46621
    PubMed ID
    23439301
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1097/MPG.0b013e3182774cae
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