Should routine screening for celiac disease be considered before starting interferon/ribavirin treatment in patients affected by chronic hepatitis C or not?

Mr, Nejad; Alavian, Seyed Moayed

doi:10.4149/bll_2012_059

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Our experience with this case raises again the important question of whether CD screening should be performed prior to initiation of interferon based therapy for chronic hepatitis C [15]. Although screening for celiac disease before initiation of interferon therapy has been suggested [16, 17], current screening recommendations for celiac disease are targeted towards pediatric and adult patients already diagnosed with certain autoimmune diseases (including autoimmune thyroid disease, autoimmune liver disease, primary biliary cirrhosis, and type 1 diabetes mellitus) [18, 19]. Screening for CD in the setting of HCV treatment with interferon has not yet been recommended.…”

Section: Discussionmentioning

confidence: 99%

Onset of Celiac Disease after Treatment of Chronic Hepatitis C with Interferon Based Triple Therapy

Singh

Zaeri

2015

Case Reports in Hepatology

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Background. Patients treated with interferon (IFN) based therapies may develop exacerbation of autoimmune disease. We herein present the case of a 53-year-old female patient who developed celiac disease (CD) as a result of triple therapy (interferon, ribavirin, and boceprevir) for chronic HCV. Case. 53-year-old Caucasian female with past medical history of IV drug abuse was referred for abnormal LFTs. Laboratory data showed HCV RNA of 4,515,392 IU/mL, HCV genotype 1a, with normal LFTs. She was treated with 4 weeks of pegylated interferon alfa-2a plus ribavirin, followed by triple therapy using boceprevir for a total of 28 weeks. Approximately 4 weeks after initiation of triple therapy patient developed loose nonbloody bowel movements and was also found to have anemia. Biopsies from first and second portions of the duodenum were consistent with CD. The patient was treated with a gluten-free diet. Her intestinal symptoms improved and the hemoglobin returned to normal. Conclusion. Chronic HCV patients being treated with interferon alfa can develop celiac disease during or after therapy. For patients with positive autoantibodies, all-oral-IFN-free regimens should be considered. Celiac disease should be considered in patients who develop CD-like symptoms while on and shortly after cessation of interferon alfa therapy.

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Section: Discussionmentioning

confidence: 99%

Onset of Celiac Disease after Treatment of Chronic Hepatitis C with Interferon Based Triple Therapy

Singh

Zaeri

2015

Case Reports in Hepatology

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Autoantibodies in chronic hepatitis C: A clinical perspective

Narciso-Schiavon

Schiavon

2015

WJH

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Non-organ-specific autoantibodies and thyroid autoantibodies have been frequently found in chronic carriers of hepatitis C virus (HCV). With respect to endomysial antibodies and tissue transglutaminase, it is controversial whether the prevalence of gluten-related seromarkers is higher in patients with HCV. In such cases, in addition to acknowledging any currently existing autoimmune disease, recognizing the risk of the patient developing an autoimmune disease during interferon (IFN)-based treatment must be a principle concern. From a clinical point-of-view, the presence of autoantibodies arouses suspicion that an autoimmune disease may be present or may be precipitated by IFN-based HCV treatment. In this paper, we review the prevalence of autoantibodies in individuals with hepatitis C, the clinical significance of these autoantibodies, and the approach recommended for such situations.

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Should routine screening for celiac disease be considered before starting interferon/ribavirin treatment in patients affected by chronic hepatitis C or not?

Cited by 2 publications

References 4 publications

Onset of Celiac Disease after Treatment of Chronic Hepatitis C with Interferon Based Triple Therapy

Onset of Celiac Disease after Treatment of Chronic Hepatitis C with Interferon Based Triple Therapy

Autoantibodies in chronic hepatitis C: A clinical perspective

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