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

作　　者：Carlo Fabbri M.Francesca Jaboli Silvia Giovanelli Francesco Azzaroli Alessandro Pezzoli Esterita Accogli Stefania Liva Giovanni Nigro Anna Miracolo Davide Festi Antonio Colecchia Marco Montagnani Enrico Roda Giuseppe Mazzella 

机构地区：[1]Department of Internal Medicine and Gastroenterology,University of Bologna,Bologna,Italy [2]Department of Medicine and Aging,University"G D'Annunzio"Chieti,Italy

出　　处：《World Journal of Gastroenterology》2003年第7期1487-1490,共4页世界胃肠病学杂志（英文版）

摘　　要：AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-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 12-month IFN protocol.We evaluated:a) the baseline prevalence of autoimmune gastritis,b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3,6 and 12 months),c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (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%) patients,respectively,at baseline,in 25 (13%) and 31 (16%) patients at the end of treatment (both P<0.001,vs baseline),and in 7 (4%) and 14 (7%) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively,vs baseline;P=not significant vs end of treatment).The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P=0.0001),no relationship was found with other markers of autoimmunity. CONCLUSION:In HCV patients,IFN frequently precipitates latent autoimmune gastritis,particularly in females.Following our 12-month protocol,the phenomenon generally regressed.Since APCA positivity and high gastrin levels are 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.AIM: To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-intefferon (IFN) treatment on autoimmune gastritis.METHODS: We performed a prospective study on 189patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol. We evaluated: a) the baseline prevalence of autoimmune gastritis, b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3, 6 and 12 months), c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (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 %) patients, respectively, at baseline, in 25 (13 %) and 31 (16 %) patients at the end of treatment (both P＜0.001, vs baseline), and in 7 (4 %) and 14 (7 %) patients 12 months after withdrawal (P=0.002and ,P=0.01 respectively, vs baseline; P=not significant vs end of treatment). The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P =0.0001), no relationship was found with other markers of autoimmunity.CONCLUSION: In HCV patients, IFN frequently precipitates latent autoimmune gastritis, particularly in females. Following our 12-month protocol, the phenomenon generally regressed. Since APCA positivity and high gastrin levels are 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.

关 键 词：Adult Aged Antiviral Agents DOSAGE Autoimmune Diseases Female GASTRINS GASTRITIS Helicobacter Infections Helicobacter pylori Hepatitis C  Chronic Humans INTERFERON-ALPHA Male Middle Aged Organ Specificity Parietal Cells  Gastric Prevalence Prospective Studies Thyroid Gland Treatment Outcome 

分 类 号：R512.6[医药卫生—内科学] R573[医药卫生—临床医学]