Viral Hepatitis
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2006; 12(36): 5787-5792
Published online Sep 28, 2006. doi: 10.3748/wjg.v12.i36.5787
Prevalence of autoantibodies and the risk of autoimmune thyroid disease in children with chronic hepatitis C virus infection treated with interferon-α
Stephan Gehring, Ulrike Kullmer, Sabine Koeppelmann, Patrick Gerner, Philip Wintermeyer, Stefan Wirth
Stephan Gehring, The Liver Research Center, Department of Medicine, Rhode Island Hospital and Brown Medical School, Providence, Rhode Island, USA and Kinderklinik der Johannes-Gutenberg-Universität, Mainz, Germany
Ulrike Kullmer, Sabine Koeppelmann, Kinderklinik der Johannes-Gutenberg-Universität, Mainz, Germany
Patrick Gerner, Philip Wintermeyer, Stefan Wirth, Zentrum für Kinder- und Jugendmedizin, HELIOS Klinikum, Wuppertal, Witten-Herdecke-University, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Dr. Stefan Wirth, Children's Hospital, HELIOS Klinikum Wuppertal, Witten-Herdecke University, Heusnerstr. 40, D-42283 Wuppertal, Germany. s-k-wirth@t-online.de
Telephone: +49-202-8963833 Fax: +49-202-8963834
Received: June 6, 2006
Revised: August 5, 2006
Accepted: August 14, 2006
Published online: September 28, 2006
Abstract

AIM: To evaluate the prevalence of autoantibodies in chronic hepatitis C virus (HCV)-infected children focusing on thyroid autoimmunity.

METHODS: We investigated the prevalence of auto-antibodies in 123 chronic HCV-infected children before, during and after monotherapy with interferon-alpha (IFN-α) or combined treatment with interferon-α or peginterferon-α and ribavirin. Besides antibodies against smooth muscle (SMA), nuclei (ANA), and liver/kidney microsomes (LKM), the incidence of anti-thyroid peroxidase antibodies as well as thyroid function parameters (TSH, FT3 and FT4) were determined.

RESULTS: We found that 8% of children had autoantibodies before treatment. During treatment, 18% of children were found positive for at least one autoantibody; 15.5% of children developed pathologic thyroid values during IFN-α treatment compared to only one child before therapy. Six children had to be substituted while developing laboratory signs of hypothyroidism.

CONCLUSION: Our data indicate a strong correlation between interferon-α treatment and autoimmune phenomena, notably the emergence of thyroid antibodies. The fact that some children required hormone replacement underlines the need of close monitoring in particularly those who respond to therapy and have to be treated for more than 6 mo.

Keywords: Hepatitis C treatment; Children; Thyroid dysfunction; Autoantibodies