Type 1 diabetes mellitus in patients with chronic hepatitis C before and after interferon therapy

Fabris, Paolo; Floreani, Annarosa; Tositti, Giulia; Vergani, Diego; Lalla, Fausto de; Betterle, Corrado

doi:10.1046/j.1365-2036.2003.01681.x

Cited by 109 publications

(86 citation statements)

References 70 publications

(103 reference statements)

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“…This report confirm that IDDM, in course of -IFN therapy, is a rare event; IFN seems to play a trigger effect on IDDM onset so as it can also amplify thyroid autoimmune response in predisposed subjects [1,[23][24][25][26][27].…”

Section: Interferons and Diabetes: A Reviewsupporting

confidence: 80%

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HCV and Diabetes Mellitus: Considerations About Effects of Interferon Therapy

Reynaud¹,

Carleo²,

Talamo³

et al. 2007

TOPHARMJ

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Nowadays HCV-related chronic hepatitis represents one of the main challenge for infectious diseases for many reasons: the dimension of the phenomenon, as millions of patients are afflicted with this pathology in the world, the dramatic consequences on the quality of their life, the economic and sanitary efforts sustained by the society, but also the stimulating results in therapeutic approach due to the introduction of interferons in monotherapy first and association therapy (IFN plus ribavirin) later in modern protocols. The results obtained with these therapies are very encouraging even if medical doctors and patients know very well that this therapy is related to some side effects that grow dramatically in number with the progression of scientific knowledge. The Authors review the literature on the relationship among HCV, IFN therapy and diabetes to understand better damages and benefits of this long debated matter and possibly add their contribution to clinical and therapeutic strategies.

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Section: Interferons and Diabetes: A Reviewsupporting

confidence: 80%

“…It is characterized by islet infiltration of Tlymphocytes and monocytes and by hyper-expression of Major Histocompatibility Complex (MHC) class I antigens [1].…”

Section: Introductionmentioning

confidence: 99%

HCV and Diabetes Mellitus: Considerations About Effects of Interferon Therapy

Reynaud¹,

Carleo²,

Talamo³

et al. 2007

TOPHARMJ

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“…One patient stopped treatment because of local allergic reaction at the injection site, and 1 girl developed type 1 diabetes mellitus, which is a rare but well-described side effect under interferon treatment. 21 Also, careful monitoring of autoimmunity regarding the thyroid gland is mandatory, because in 15% thyroid antibodies emerged under long-term treatment. Thyroidstimulating hormone levels also have to be controlled on a regular basis.…”

Section: Discussionmentioning

confidence: 99%

Peginterferon alfa-2b plus ribavirin treatment in children and adolescents with chronic hepatitis C

et al. 2005

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Peginterferon plus ribavirin is standard therapy for adults with chronic hepatitis C. As no data are available for children, the aim of the study was to evaluate the efficacy and tolerability of peginterferon alfa-2b in combination with ribavirin in chronically infected children. Genotypes, alanine aminotransferase levels, and different routes of viral transmission were considered. In an open-labeled, uncontrolled pilot study, 62 children and adolescents (range, 2-17 years) were treated with subcutaneous peginterferon alfa-2b at a dose of 1.5 g/kg body weight once per week plus oral ribavirin (15 mg/kg ؋ day) for 48 weeks. Sixty-one patients completed the study. Twenty-three children discontinued therapy after 6 months according to study protocol. P eginterferon alfa and ribavirin is established as standard treatment in adults with chronic hepatitis C (HCV). International studies have yielded sustained viral response rates (SVR) between 44% and 75% according to the genotype. 1,2 Whereas interferon alfa-2b and ribavirin has been approved for individuals between 3 and 18 years of age in the United States, the indication for therapy in children and adolescents is still debated in many countries. One reason may be that ribavirin has teratogenic or embryocidal effects in animals. The risk of ribavirin as a carcinogen in humans has not been established. For more than 20 years, the substance has been used in infants for other indications, such as respiratory syncytial virus infection.The usage of peginterferon has improved response rates in adults by approximately 10% compared with a treatment regimen with interferon-alfa and ribavirin. Moreover, dosing of peginterferon once per week is another considerable advantage. No treatment study with peginterferon-alfa and ribavirin in children and adolescents with chronic HCV has been published so far.Chronic HCV in childhood features particular issues regarding mode of infection, immunological competence, and inflammatory activity. Vertical infection is the most important route of viral transmission. 3 These children are infected at a phase of high immune tolerance. A considerable number of young individuals display normal aminotransferases, reflecting a low inflammatory activity. Despite a relatively low disease progression during the first 15 to 20 years of life, severe liver disease occasionally occurs during childhood. In vertically infected patients, long-term spontaneous clearance of chronic HCV is low, SVR, sustained viral response; HCV RNA, hepatitis C virus ribonucleic acid; ALT, alanine aminotransferase. From the

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“…In 1992, it was documented for the first time that IFN therapy for chronic hepatitis C can induce T1D (13), and this was followed by similar case reports (reviewed in (19) (22,23). RBV administration should be avoided in patients with T1D-susceptible HLA.…”

Section: T1d Is At Least In Part An Autoimmune Disease Character-izedmentioning

confidence: 98%

Peginterferon (PEG-IFN) Plus Ribavirin Combination Therapy, but neither Interferon nor PGE-IFN Alone, Induced Type 1 Diabetes in a Patient with Chronic Hepatitis C

et al. 2009

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Type 1 diabetes mellitus in patients with chronic hepatitis C before and after interferon therapy

Cited by 109 publications

References 70 publications

HCV and Diabetes Mellitus: Considerations About Effects of Interferon Therapy

HCV and Diabetes Mellitus: Considerations About Effects of Interferon Therapy

Peginterferon alfa-2b plus ribavirin treatment in children and adolescents with chronic hepatitis C

Peginterferon (PEG-IFN) Plus Ribavirin Combination Therapy, but neither Interferon nor PGE-IFN Alone, Induced Type 1 Diabetes in a Patient with Chronic Hepatitis C

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