Researchers from Italy undertook a study to assess the impact of interferon treatment on celiac disease onset in hepatitis C patients and to clarify its clinical relevance and outcome.
Hepatitis C is associated with autoimmunity, which can be exacerbated by interferon treatment.
Cases of celiac disease activation during interferon treatment have been reported.
In this retrospective study, the researchers included 534 hepatitis C patients with or without symptoms compatible with celiac disease onset during interferon treatment and 225 controls.
The researchers assayed anti-transglutaminase antibodies and typed HLA-DQA1 and -B1 loci.
The research team confirmed the diagnosis in antibody-positive patients using upper gastrointestinal endoscopy.
|86% of patients with anti-transglutaminase antibodies showed activation of celiac disease while on interferon|
|Journal of Clinical Gatroenterology|
Anti-transglutaminase antibodies were detected before treatment in 1.3% of hepatitis C patients and in 0.4% of controls (not significant).
The researchers found that 86% of patients with anti-transglutaminase antibodies showed activation of celiac disease while on interferon.
The team noted that symptoms ranged from mild to severe, and interferon had to be discontinued in 2 of 7 (29%) patients.
In addition, the researchers found that symptoms disappeared in 6 of 7 patients fter interferon withdrawal.
Onset of symptoms compatible with celiac disease during interferon therapy was significantly associated with the presence of anti-transglutaminase antibodies.
Dr Durante-Mangoni concluded, "In hepatitis C patients, the activation of silent celiac disease during interferon treatment is almost universal and should be suspected, but it uncommonly requires interferon treatment discontinuation."
"Symptoms subside after interferon withdrawal."