The team assessed the prevalence and risk factors of hepatitis C (HCV) and B virus (HBV) infection in Crohn's disease (CD).
They reported their findings in the November issue of Inflammatory Bowel Diseases.
The effect of immunomodulatory drugs for CD on the clinical course of hepatitis virus infections was examined in a small number of patients. In addition, the effect of interferon-alpha (IFN-alpha) on the course of CD was investigated.
Sera from 332 CD patients and 374 control subjects were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), HBcAb, HBeAg, HBeAb, anti-HCV, and HCV-RNA.
An additional 162 patients with ulcerative colitis (UC) were tested as a disease control group.
Infection by either HCV or HBV was detected in 25% of patients with CD.
In the age groups younger than 50 years, HCV prevalence was higher in CD than in the controls.
HCV infection in CD was associated with surgery (OR 1.71), blood transfusions (OR 3.39), and age (OR 2.3).
| HCV or HBV detected in 25% of Crohn's patients.
| Inflammatory Bowel Diseases |
The team found that the event CD-related surgery appeared to be the main risk factor for HCV infection in CD.
HCV prevalence was found to be higher in CD (7.4%) than in UC (0.6%).
HBcAb positivity was higher in CD (10.9%) and UC (11.5%), than in controls (5.1%). It was associated with age (OR 2.08) and female gender (OR 2.68) in CD, and with UC duration (OR 1.20).
In addition, the team found that immunomodulatory drugs did not influence the course of HBV or HCV infection in 7 patients with CD. Nor did IFN-alpha for chronic hepatitis C affect CD activity in 6 patients with CD.
Livia Biancone, of the Universita di Roma Tor Vergata, said on behalf of colleagues, "HBV prevalence is higher in CD than in controls at all ages. However, HCV prevalence is increased in young patients with CD, because of a greater need for surgery.
"The higher HCV (but not HBV) prevalence in CD than in UC suggests that the host immune response may influence the risk of HCV infection."
"Although a relatively high proportion of patients with CD showed HBV and/or HCV infections, this should not influence treatment strategies for CD," it was concluded.