Type C-chronic hepatitis patients who had autoimmune phenomenon and developed jaundice during interferon therapy

J Gastroenterol. 2003;38(5):493-500. doi: 10.1007/s00535-002-1090-7.

Abstract

Of a total of 2342 patients with type-C chronic hepatitis treated with interferon (IFN) at this hospital, 3 patients developed jaundice during the course of IFN therapy, but all 3 of them exhibited negative conversion of hepatitis C virus (HCV)-RNA following readministration of IFN. All 3 patients were assessed as having "probable autoimmune hepatitis (AIH)" in accordance with the AIH scoring system, indicating association with an "autoimmune phenomenon". Readministration of IFN at a low-dose induced activation of the autoimmune phenomenon, leading to fulminant hepatocellular impairment. As a result, HCV-RNA content dropped dramatically, possibly contributing to the negative conversion of HCV-RNA noted following the readministration of IFN. At present, no adequate therapy has been established for type-C chronic hepatitis with autoimmune manifestations. However, in conclusion, our findings suggested that: IFN should be a frontline regiment: (1). if autoantibody titers are low or patients are rated as having "probable AIH" or lower in accordance with the AIH scoring system, indicating a strong link to chronic hepatitis or (2). if IFN is expected to be efficacious on the basis of genotype of HCV-RNA level; even if there is acute exacerbation of type-C chronic hepatitis, IFN should be re-administered in the HCV-RNA level has dropped subsequently.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Aspartate Aminotransferases / blood
  • Female
  • Genotype
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / immunology
  • Hepatitis, Autoimmune / blood*
  • Hepatitis, Autoimmune / immunology
  • Humans
  • Interferon-beta / administration & dosage
  • Interferon-beta / adverse effects*
  • Interferon-beta / therapeutic use
  • Jaundice / immunology
  • Male
  • Middle Aged
  • RNA, Viral / analysis

Substances

  • Antiviral Agents
  • RNA, Viral
  • Interferon-beta
  • Aspartate Aminotransferases
  • Alanine Transaminase