Skip to main content

Advertisement

Log in

Hepatitis C Virus and Inflammatory Bowel Disease

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Gastroenterologists frequently treat patients with complex illnesses such as chronic hepatitis C infections and inflammatory bowel disease (IBD). Occasionally, a patient will present with these two diseases which behave very differently and the treatment for one may potentially exacerbate the other. The purpose of this article is to review the current literature regarding hepatitis C virus therapy in the setting of IBD as well as the effects of common IBD therapies on the hepatitis C virus. Based on limited data, anti-viral therapy is probably safe in patients with well-controlled IBD, but there might be a risk of causing new onset of IBD. Also, it does not appear that the commonly used medications for IBD have much of an effect on the hepatitis C virus (HCV) or its course.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Longo F, Hebuterne X, Tran A, et al. Prevalence of hepatitis C in patients with chronic inflammatory bowel disease in the region of Nice and evaluation of risk factors. Gastroenterol Clin Biol. 2000;24(1):77–81.

    PubMed  CAS  Google Scholar 

  2. Bronowicki JP, Barraud H, Peyrin-Biroulet L. Epidemiology and natural history of hepatitis C. Rev Prat. 2005;55(6):607–614.

    PubMed  Google Scholar 

  3. Biancone L, Pavia M, Del Vecchio Blanco G, et al. Hepatitis B and C virus infection in Crohn’s disease. Inflamm Bowel Dis. 2001;7(4):287–294. doi:10.1097/00054725-200111000-00002.

    Article  PubMed  CAS  Google Scholar 

  4. Khalil A, Lucidarme D, Desurmont P, et al. Crohn’s disease associated with interferon and ribavirin treatment for chronic hepatitis C. Gastroenterol Clin Biol. 2005;29(2):193–196. doi:10.1016/S0399-8320(05)80736-5.

    Article  PubMed  Google Scholar 

  5. Villa F, Rumi MG, Signorelli C, et al. Onset of inflammatory bowel diseases during combined alpha-interferon and ribavirin therapy for chronic hepatitis C: report of two cases. Eur J Gastroenterol Hepatol. 2005;17(11):1243–1245. doi:10.1097/00042737-200511000-00015.

    Article  PubMed  Google Scholar 

  6. Mavrogiannis C, Papanikolaou IS, Elefsiniotis IS, et al. Ulcerative colitis associated with interferon treatment for chronic hepatitis C. J Hepatol. 2001;34(6):964–965. doi:10.1016/S0168-8278(01)00022-8.

    Article  PubMed  CAS  Google Scholar 

  7. Sprenger R, Sagmeister M, Offner F. Acute ulcerative colitis during successful interferon/ribavirin treatment for chronic hepatitis. Gut. 2003;52(12):1728–1733. doi:10.1136/gut.52.12.1728.

    Article  Google Scholar 

  8. Niki T, Nishida K, Honsako Y, et al. A case of ulcerative colitis along with characteristic features on computed tomography (CT), developed by the treatment with interferon for chronic hepatitis C. Nippon Shokakibyo Gakkai Zasshi. 2001;98(4):399–404.

    PubMed  CAS  Google Scholar 

  9. Watanabe T, Inoue M, Harada K, et al. A case of exacerbation of ulcerative colitis induced by combination therapy with PEG-interferon alpha-2b and ribavirin. Gut. 2006;55(11):1682–1683. doi:10.1136/gut.2006.105197.

    Article  PubMed  CAS  Google Scholar 

  10. Mitoro A, Yoshikawa M, Yamamoto K, et al. Exacerbation of ulcerative colitis during alpha-interferon therapy for chronic hepatitis C. Intern Med. 1993;32(4):327–331. doi:10.2169/internalmedicine.32.327.

    Article  PubMed  CAS  Google Scholar 

  11. Yamamoto Y, Sakatani N, Yano S, et al. Interferon-induced IBD-like acute colitis–two cases of patients with chronic active hepatitis. Nippon Shokakibyo Gakkai Zasshi. 1995;92(9):1293–1296.

    PubMed  CAS  Google Scholar 

  12. Cottone M, Magliocco A, Trallori G, et al. Clinical course of inflammatory bowel disease during treatment with interferon for associated chronic active hepatitis. Ital J Gastroenterol. 1995;27(1):3–4.

    PubMed  CAS  Google Scholar 

  13. Bargiggia S, Thorburn D, Anderloni A, et al. Is interferon-alpha therapy safe and effective for patients with chronic hepatitis C and inflammatory bowel disease? A case-control study. Aliment Pharmacol Ther. 2005;22(3):209–215.

    Article  PubMed  CAS  Google Scholar 

  14. Tilg H, Vogelsang H, Ludwiczek O, et al. A randomized placebo-controlled trial of pegylated interferon alpha in active ulcerative colitis. Gut. 2003;52(12):1728–1733. doi:10.1136/gut.52.12.1728.

    Article  PubMed  CAS  Google Scholar 

  15. Esteve M, Saro C, Gonzalex-Huix F, et al. Chronic hepatitis B reactivation following infliximab therapy in Crohn’s disease patients: need for primary prophylaxis. Gut. 2004;53:1363–1365. doi:10.1136/gut.2004.040675.

    Article  PubMed  CAS  Google Scholar 

  16. Ueno Y, Tanaka S, Shimamoto M, et al. Infliximab therapy for Crohn’s disease in a patient with chronic hepatitis B. Dig Dis Sci. 2005;50:163–166. doi:10.1007/s10620-005-1295-8.

    Article  PubMed  Google Scholar 

  17. Garcia-Sanchez M, Gomez-Camacho F, Poyato-Gonzalez A, et al. Infliximab therapy in a patient with Crohn’s disease and chronic hepatitis B virus infection. Inflamm Bowel Dis. 2004;10:701–702. doi:10.1097/00054725-200409000-00035.

    Article  Google Scholar 

  18. Wendling D, Auge B, Bettinger D, et al. Reactivation of a latent precore mutant hepatitis B virus-related chronic hepatitis during infliximab treatment for severe spondyloarthropathy. Ann Rheum Dis. 2005;64:788–789. doi:10.1136/ard.2004.031187.

    Article  PubMed  CAS  Google Scholar 

  19. Ostuni P, Botsios C, Punzi L, et al. Hepatitis B reactivation in a chronic hepatitis B surface antigen carrier with rheumatoid arthritis treated with infliximab and low-dose methotrexate. Ann Rheum Dis. 2003;62:686–687. doi:10.1136/ard.62.7.686.

    Article  PubMed  CAS  Google Scholar 

  20. Michel M, Duvoux C, Hezode C, et al. Fulminant hepatitis after infliximab in a patient with hepatitis B virus treated for an adult-onset Still’s disease. J Rheum. 2003;30:1624–1625.

    PubMed  Google Scholar 

  21. Peterson JR, Hsu FC, Simkin PA, et al. Effect of tumor necrosis factor alpha antagonists on serum transaminases and viraemia in patients with rheumatoid arthritis and chronic hepatitis C infection. Ann Rheum Dis. 2003;62:1078–1082. doi:10.1136/ard.62.11.1078.

    Article  PubMed  CAS  Google Scholar 

  22. Oniankitan O, Duvoux C, Challine D, et al. Infliximab therapy for rheumatic diseases in patients with chronic hepatitis B or C. J Rheum. 2004;31:107–109.

    PubMed  CAS  Google Scholar 

  23. Parke FA, Reveille JD. Anti-tumor necrosis factor agents for RA in the setting of chronic hepatitis C infection. Arthritis Rheum. 2004;51:800–804. doi:10.1002/art.20702.

    Article  PubMed  CAS  Google Scholar 

  24. Roux CH, Brocq O, Breuil V, et al. Safety of anti-TNF-alpha therapy in rheumatoid arthritis and spondylarthropathies with concurrent B or C chronic hepatitis. Rheumatology. 2006;45(10):1294–1297. doi:10.1093/rheumatology/kel123.

    Article  PubMed  CAS  Google Scholar 

  25. Aslanidis S, Vassiliadis T, Pyrpasopoulou A, et al. Inhibition of TNF-alpha does not induce viral reactivation in patients with chronic hepatitis C infection: two cases. Clin Rheumatol. 2007;26(2):261–264. doi:10.1007/s10067-006-0394-z.

    Article  PubMed  CAS  Google Scholar 

  26. Pitarch G, Sanchez-Carazo JL, Mahiques L, et al. Treatment of psoriasis with adalimumab. Clin Exp Dermatol. 2007;32(1):18–22.

    PubMed  CAS  Google Scholar 

  27. Campbell S, Ghosh S. Infliximab therapy for Crohn’s disease in the presence of chronic hepatitis C infection. Eur J Gastroenterol Hepatol. 2001;13:191–192. doi:10.1097/00042737-200102000-00016.

    Article  PubMed  CAS  Google Scholar 

  28. Holtmann MH, Galle PR, Neurath MF. Treatment of patients with Crohn’s disease and concomitant chronic hepatitis C with a chimeric monoclonal antibody to TNF. Am J Gastroenterol. 2003;98:504–505. doi:10.1111/j.1572-0241.2003.07245.x.

    Article  PubMed  Google Scholar 

  29. Zein NN, Etanercept Study Group. Etanercept as an adjuvant to interferon and ribavirin in treatment-naïve patients with chronic hepatitis C virus infection: a phase 2 randomized, double-blind, placebo-controlled study. J Hepatol. 2005;42(3):315–322. doi:10.1016/j.jhep.2004.11.025.

    Article  PubMed  CAS  Google Scholar 

  30. Nathan DM, Angus PW, Gibson PR. Hepatitis B and C virus infections and anti-tumor necrosis factor-alpha therapy: guidelines for clinical approach. J Gastroenterol Hepatol. 2006;21(9):1366–1371.

    Article  PubMed  CAS  Google Scholar 

  31. Stangl JR, Carroll KL, Illichmann M, et al. Effect of antimetabolite immunosuppressants on Flaviviridae, including hepatitis C virus. Transplantation. 2004;77(4):562–567. doi:10.1097/01.TP.0000114610.40412.C6.

    Article  PubMed  CAS  Google Scholar 

  32. Samonakis DN, Triantos CK, et al. Immunosuppression and donor age with respect to severity of HCV recurrence after liver transplantation. Liver Transpl. 2005;11(4):384–385. doi:10.1002/lt.20344.

    Article  Google Scholar 

  33. Zekry A, Gleeson M, Guney S, et al. A prospective cross-over study comparing the effect of mycophenolate versus azathioprine on allograft function and viral load in liver transplant recipients with recurrent chronic HCV infection. Liver Transpl. 2004;10(1):52–57. doi:10.1002/lt.20000.

    Article  PubMed  Google Scholar 

  34. Walter T, Dumortier J, Guillaud O, et al. Factors influencing the progression of fibrosis in patients with recurrent hepatitis C after liver transplantation under antiviral therapy: a retrospective analysis of 939 liver biopsiesin a single center. Liver Transpl. 2007;13(2):294–301. doi:10.1002/lt.21000.

    Article  PubMed  Google Scholar 

  35. Contreras AM, Monteon FJ, Flores MR, et al. Drug-related hepatotoxicity in a renal transplant recipient with long-term survival and hepatitis C. Ann Hepatol. 2007;6(1):70–73.

    PubMed  Google Scholar 

  36. Mok MY, Ng WL, Yuen MF, et al. Safety of disease modifying anti-rheumatic agents in rheumatoid arthritis patients with chronic viral hepatitis. Clin Exp Rheumatol. 2000;18(3):363–368.

    PubMed  CAS  Google Scholar 

  37. Kujawska A, Clements M, Wise CM, et al. Hepatitis C and methotrexate. Arthritis Rheum. 2003;49(6):843–845.

    Article  PubMed  Google Scholar 

  38. Firpi RJ, Zhu H, Morelli G, et al. Cyclosporine suppresses hepatitis C virus in vitro and increases the chance of a sustained virological response after liver transplantation. Liver Transpl. 2006;12(1):51–57. doi:10.1002/lt.20532.

    Article  PubMed  Google Scholar 

  39. Schiavon LL, Carvalho-Filho RJ, Narciso-Schiavon JL, et al. Impact of cyclosporine-based immunosuppressive therapy on liver histology of hepatitis C virus-infected renal transplant patients. Hepatology. 2008;48(1):348–349. doi:10.1002/hep.22331.

    Article  PubMed  Google Scholar 

  40. Wiesner RH, Shorr JS, Steffen BJ, et al. Mycophenolate mofetil combination therapy improves long-term outcomes after liver transplantation in patients with and without hepatitis C. Liver Transpl. 2005;11(7):750–759. doi:10.1002/lt.20453.

    Article  PubMed  Google Scholar 

  41. Sánchez-Bueno F, Ortiz ML, Bermejo J, et al. Prognostic factors for hepatitis C recurrence in patients undergoing orthotopic liver transplantation. Transpl Immunol. 2006;17(1):47–50. doi:10.1016/j.trim.2006.09.029.

    Article  PubMed  CAS  Google Scholar 

  42. Kato T, Gaynor JJ, Yoshida H, et al. Randomized trial of steroid-free induction versus corticosteroid maintenance among orthotopic liver transplant recipients with hepatitis C virus: impact on hepatic fibrosis progression at 1 year. Transplantation. 2007;84(7):829–835.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luis R. Peña.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Horn, T.L., Reynolds, J., de Villiers, W. et al. Hepatitis C Virus and Inflammatory Bowel Disease. Dig Dis Sci 54, 1171–1177 (2009). https://doi.org/10.1007/s10620-008-0489-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0489-2

Keywords

Navigation