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Digestive Diseases and Sciences

, Volume 53, Issue 8, pp 2151–2155 | Cite as

Celiac Disease and Non-organ-specific Autoantibodies in Patients with Chronic Hepatitis C Virus Infection

  • Caterina Ruggeri
  • Agata Tiziana La Masa
  • Stefania Rudi
  • Giovanni Squadrito
  • Giuseppe Di Pasquale
  • Sergio Maimone
  • Gaia Caccamo
  • Salvatore Pellegrino
  • Giovanni Raimondo
  • Giuseppe MagazzùEmail author
Original Paper

Abstract

Objective Considering that celiac disease (CD) is an autoimmune-based entity and the hepatitis C virus is suspected of being able to trigging autoimmune reactions, it has been hypothesized that hepatitis C virus infection might predispose to CD. The aim of this study was to investigate CD-related antibodies in a large series of hepatitis C virus-infected subjects that were also tested for non-organ-specific autoantibodies (NOSA) as indirect marker of autoimmune disorders. Methods Two hundred and forty-four patients with chronic hepatitis C virus infection (HCV-patients) and 121 patients with HCV-negative liver disease (non-HCV-patients) underwent NOSA determination and celiac serology (firstly, anti-tissue transglutaminase antibodies, then the cases which tested positive were subsequently evaluated for the presence of antiendomysial antibodies). Serum samples from 42 of the HCV-patients who underwent interferon-alpha therapy after enrolment were tested for celiac antibodies and NOSA even after stopping treatment. Additionally, sera from 1,230 blood donors were assayed for celiac serology as healthy control population. Results Positive anti-endomysial antibodies (AEA) were found in 5/244 (2%) HCV-patients, 1/121 (0.8%) non-HCV-patients and 2/1,230 (0.16%) blood donors, with a significant difference between HCV-patients and blood donors (P = 0.02; Odds ratio 12.8; 95% Confidence Interval 2.4–66). NOSA were found in 51 HCV-patients but only one of them had positive AEA. Eight out of 42 HCV-patients treated with interferon-alpha developed NOSA under therapy and none of them had CD antibodies. Conclusions AEA occur in 2% of HCV-patients and their presence is independent of other patterns of autoimmunity.

Keywords

Celiac disease Chronic hepatitis C virus infection Non-organ-specific autoantibodies Anti-endomysial antibodies Interferon alpha 

Notes

Acknowledgment

Dedicated to the memory of Professor Giuseppe Di Pasquale.

References

  1. 1.
    Kagnoff MF (2005) Overview and pathogenesis of celiac disease. Gastroenterology 128(4 Suppl 1):S10–S18PubMedCrossRefGoogle Scholar
  2. 2.
    Volta U, De Franceschi L, Molinaro N et al (1998) Frequency and significance of anti-gliadin and anti-endomysial antibodies in autoimmune hepatitis. Dig Dis Sci 43:2190–2195PubMedCrossRefGoogle Scholar
  3. 3.
    Dickey W, McMillan SA, Callender ME (1997) High prevalence of celiac sprue among patients with primary biliary cirrhosis. J Clin Gastroenterol 25:328–329PubMedCrossRefGoogle Scholar
  4. 4.
    Kingham JG, Parker DR (1998) The association between primary biliary cirrhosis and celiac disease: a study of relative prevalences. Gut 42:120–122PubMedGoogle Scholar
  5. 5.
    Floreani A, Betterle C, Baragiotto A et al (2002) Prevalence of coeliac disease in primary biliary cirrhosis and of antimitochondrial antibodies in adult coeliac disease patients in Italy. Dig Liver Dis 34:258–261PubMedCrossRefGoogle Scholar
  6. 6.
    Volta U, Rodrigo L, Granito A et al (2002) Celiac disease in autoimmune cholestatic liver disorders. Am J Gastroenterol 97:2609–2613PubMedCrossRefGoogle Scholar
  7. 7.
    Volta U, De Franceschi L, Lari F et al (1998) Coeliac disease hidden by cryptogenic hypertransaminasaemia. Lancet 35:26–29CrossRefGoogle Scholar
  8. 8.
    Bardella MT, Vecchi M, Conte D et al (1999) Chronic unexplained hypertransaminasemia may be caused by occult celiac disease. Hepatology 29:654–657PubMedCrossRefGoogle Scholar
  9. 9.
    Lo Iacono O, Petta S, Venezia G et al (2005) Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always celiac disease? Am J Gastroenterol 100:2472–2477PubMedCrossRefGoogle Scholar
  10. 10.
    Fine KD, Ogunji F, Saloum Y et al (2001) Celiac Sprue: another autoimmune Syndrome associated with hepatitis C. Am J Gastroenterol 96:138–145PubMedCrossRefGoogle Scholar
  11. 11.
    Bardella MT, Marino R, Meroni PL (1999) Celiac disease during interferon treatment. Ann Intern Med 131:157–158PubMedGoogle Scholar
  12. 12.
    Cammarota G, Cuoco L, Pandolfi F et al (2000) Onset of coeliac disease during treatment with interferon for chronic hepatitis C. Lancet 356:1494–1495PubMedCrossRefGoogle Scholar
  13. 13.
    Adinolfi LE, Durante-Mangoni E, Andreana A (2001) Interferon and ribavirin treatment for chronic hepatitis C may activate celiac disease. Am J Gastroenterol 96:607–608PubMedCrossRefGoogle Scholar
  14. 14.
    Bourliere M, Oules V, Perrier H et al (2001) Onset of coeliac disease and interferon treatment. Lancet 357:803–804PubMedCrossRefGoogle Scholar
  15. 15.
    Narvaez I, Perez B, del Mar Alcade M et al (2003) Chronic viral hepatitis, interferon, diabetes mellitus, and celiac disease. Am J Gastroenterol 98:2336–2337PubMedCrossRefGoogle Scholar
  16. 16.
    Durante-Mangoni E, Iardino P, Resse M et al (2004) Silent celiac disease in chronic hepatitis C: impact of interferon treatment on the disease onset and clinical outcome. J Clin Gastroenterol 38:901–905PubMedCrossRefGoogle Scholar
  17. 17.
    Martins EV Jr, Gaburri AK (2004) Celiac disease onset after pegylated interferon and ribavirin treatment of chronic hepatitis C. Arq Gastroenterol 4:132–133Google Scholar
  18. 18.
    Scoglio R, Di Pasquale G, Pagano G et al (2003) Is intestinal biopsy always needed for diagnosis of celiac disease? Am J Gastroenterol 98:1325–1331PubMedCrossRefGoogle Scholar
  19. 19.
    Not T, Horvath K, Hill ID et al (1998) Celiac disease risk in the USA: high prevalence of antiendomysium antibodies in healthy blood donors. Scand J Gastroenterol 33:494–498PubMedCrossRefGoogle Scholar
  20. 20.
    Squadrito G, Previti M, Lenzi M et al (2003) High prevalence of non-organ-specific autoantibodies in hepatitis C virus infected cirrhotic patients from southern Italy. Dig Dis Sci 48:349–353PubMedCrossRefGoogle Scholar
  21. 21.
    Sagnelli E, Stroffolini T, Almasio P et al (2005) The relevance of hepatitis C virus infection in the burden of chronic liver disease in Italy. J Med Virol 75:525–527Google Scholar
  22. 22.
    Trevisiol C, Not T, Berti I et al (1999) Screening for coeliac disease in healthy blood donors at two immuno-transfusion centres in north-east Italy. Ital J Gastroenterol Hepatol 31:584–586PubMedGoogle Scholar
  23. 23.
    Vogelsang H, Genser D, Wyatt J et al (1995) Screening for celiac disease: a prospective study on the value of non invasive tests. Am J Gastroenterol 90:394–398PubMedGoogle Scholar
  24. 24.
    Carroccio A, Iacono G, Montalto G et al (1993) Immunologic and absorptive tests in celiac disease: can they replace intestinal biopsies? Scand J Gastroenterol 28:673–676PubMedCrossRefGoogle Scholar
  25. 25.
    Corazza GR, Andreani ML, Biagi F et al (1997) The smaller size of the ‘coeliac iceberg’ in adults. Scand J Gastroenterol 32:917–919PubMedCrossRefGoogle Scholar
  26. 26.
    Johnson RJ, Gretch DR, Yamabe H et al (1993) Membranoproliferative glomerulonephritis associated with hepatitis C virus infection. N Engl J Med 328:465–470PubMedCrossRefGoogle Scholar
  27. 27.
    Tran A, Quaranta JF, Benzanken S et al (1993) High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy. Hepatology 18:253–257PubMedGoogle Scholar
  28. 28.
    Lunel F, Musset L, Cacoub P et al (1994) Cryoglobulinemia in chronic liver disease: role of hepatitis C virus and liver damage. Gastroenterology 106:1291–1300PubMedGoogle Scholar
  29. 29.
    Adinolfi LE, Utili R, Attanasio V et al (1996) Epidemiology, clinical spectrum and prognostic value of mixed cryoglobulinemia in hepatitis C virus patients. A prospective study. Ital J Gastroenterol 28:1–9PubMedGoogle Scholar
  30. 30.
    Obermayer-Straub P, Manns MP (2001) Heapatitis C and D, retroviruses and autoimmune manifestations. J Autoimm 16:275–285CrossRefGoogle Scholar
  31. 31.
    Lenzi M, Bellentani S, Saccoccio G et al (1999) Prevelance of non-organ-specific autoantibodies and chronic liver disease in the general population: a nested-case-control study of the Dyonysos cohort. GUT 45:435–441PubMedCrossRefGoogle Scholar
  32. 32.
    Davison S (2002) Celiac disease and liver dysfunction. Arch Dis Child 87:293–296PubMedCrossRefGoogle Scholar
  33. 33.
    McKiernan SM, Hagan R, Curry M et al (2004) MHC class I and II alleles are associated with hepatitis C viral clearance, originating from a single source. Hepatology 40:108–114PubMedCrossRefGoogle Scholar
  34. 34.
    Chiang BL, Yang PM, Hwang LH et al (1998) Establishment and characterization of NS3 protein specific T-cell clones from a patient with chronic hepatitis C. J Biomed Sci 5:290–296PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Caterina Ruggeri
    • 1
  • Agata Tiziana La Masa
    • 2
  • Stefania Rudi
    • 1
  • Giovanni Squadrito
    • 2
  • Giuseppe Di Pasquale
    • 1
  • Sergio Maimone
    • 2
  • Gaia Caccamo
    • 2
  • Salvatore Pellegrino
    • 1
  • Giovanni Raimondo
    • 2
  • Giuseppe Magazzù
    • 1
    Email author
  1. 1.Cystic Fibrosis and Paediatric Gastroenterology Unit, Dipartimento di Scienze pediatriche mediche e chirurgicheUniversità di MessinaMessinaItaly
  2. 2.U.O. di Epatologia Clinica e Biomolecolare, Dipartimento di Medicina InternaUniversità di MessinaMessinaItaly

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