Gastric autoimmune disorders in patients with chronic hepatitis C before,during and after interferon

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:lijian6185
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AIM:To explore the prevalence of autoimmune gastritis inchronic hepatitis C virus (HCV) patients and the influence ofα-interferon (IFN) treatment on autoimmune gastritis.METHODS:We performed a prospective study on 189patients with positive anti-HCV and viral RNA enrolled in a12-month IFN protocol.We evaluated:a) the baselineprevalence of autoimmune gastritis,b) the impact of IFNtreatment on development of biochemical signs of autoimmunegastritis (at 3,6 and 12 months),c) the evolution after IFNwithdrawal (12 months) in terms of anti-gastric-parietal-cellantibodies (APCA),gastrin,anti-thyroid,and anti-non-organ-specific antibodies.RESULTS:APCA positivity and 3-fold gastrin levels weredetected in 3 (1.6%) and 9 (5%) patients,respectively,atbaseline,in 25 (13%) and 31 (16%) patients at the end oftreatment (both P<0.001,vs baseline),and in 7 (4%) and14 (7%) patients 12 months after withdrawal (P=0.002and P=0.01 respectively,vs baseline;P=not significant vsend of treatment).The development of autoimmune gastritiswas strictly associated with the presence of autoimmunethyroiditis (P=0.0001),no relationship was found with othermarkers of autoimmunity.CONCLUSION:In HCV patients,IFN frequently precipitateslatent autoimmune gastritis,particularly in females.Followingour 12-month protocol,the phenomenon generallyregressed.Since APCA positivity and high gastrin levels areassociated with the presence of antithyroid antibodies,development of autoimmune thyroiditis during IFN treatmentmay provide a surrogate preliminary indicator of possibleautoimmune gastritis to limit the need for invasive examinations. AIM: To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of alpha-interferon (IFN) treatment on autoimmune gastritis. METHODS: We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a) the baselineprevalence of autoimmune gastritis, b) the impact of IFN treatment on development of biochemical signs of autoimmunegastritis (at 3, 6 and 12 months), c) the evolution after IFNwithdrawal (12 months) in terms of anti-gastric-parietal-cellantibodies (APCA), gastrin, anti-thyroid, and anti-non-organ- specific antibodies .RESULTS: APCA positivity and 3- fold gastrin levels were detected in 3 (1.6%) and 9 5% of patients at atline, in 25 (13%) and 31 (16%) patients at the end of treatment (both P <0.001 vs vs baseline), and in 7 (4%) and 14 months after withdrawal (P = 0.002 and P = 0.01 respectively, vs baseline; P = not significant vsend of treatment) of autoimmune gastritis was strictly associated with the presence of autoimmunethyroiditis (P = 0.0001), no relationship was found with other markers of autoimmunity. CONCLUSION: In HCV patients, IFN frequently precipitates platent autoimmune gastritis, particularly in females. Popular process 12-month protocol, the phenomenon generallyregressed .ince APCA positivity and high gastrin levels area associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.
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