Journal Information
Vol. 35. Issue. 5.September - October 2015
Pages 421-516
Vol. 35. Issue. 5.September - October 2015
Pages 421-516
Letter to the Editor
DOI: 10.1016/j.nefroe.2015.04.003
Open Access
Reply to the comment “Infection with hepatitis C virus, interferon α and lupus: An odd association”
Respuesta al comentario de «Infección por virus de la hepatitis C, interferón α y lupus, una curiosa asociación»
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Pilar Auñón
Corresponding author
, Enrique Morales
Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Dear Editor:

We hereby thank Dr Martín-Gómez for her interest in our article “Infection with hepatitis C virus, interferon α and lupus: An odd association”1 and her comment on it.

As she clearly explains in her remark, the presence of antinuclear antibodies (ANA) among patients with chronic HCV infection has been extensively described in the literature as an immune epiphenomenon lacking clinical significance in most cases.2

Additional supporting tests, including extending the autoantibody profile, should only be performed in patients whose clinical or analytical findings are unrelated to hepatitis C. This rules out associated diseases, such as autoimmune hepatitis or drug-induced lupus.

Following treatment, our patient had fever, asthenia, and arthralgia, as well as positive anti-histone antibodies. The temporal relationship between concomitant interferon treatment and negative HCV tests resulted in the diagnosis and subsequent therapy of the patient.

By contrast, the advent of new drugs for the treatment of HCV, such as the nucleotide NS5B polymerase inhibitor, sofosbuvir, and the NS5A inhibitor, daclatasvir, paves the way for interferon-free treatments. These new drugs will avoid the interferon-associated adverse effects, while achieving highly sustained virologic response rates. However, further studies should be conducted in special populations,3 including patients with end-stage renal disease undergoing haemodialysis.

References
[1]
P. Auñón-Rubio, E. Hernández-Martínez, A. Sevillano-Prieto, E. Morales-Ruiz.
Infección por virus de la hepatitis C, interferón alfa y lupus, una curiosa asociación.
[2]
C. Palazzi, D. Buskila, S. D’Angelo, E. D’Amico, I. Olivieri.
Autoantibodies in patients with chronic hepatitis C virus infection: pitfalls for the diagnosis of rheumatic diseases.
Autoimmun Rev, 11 (2012), pp. 659-663
[3]
M.S. Sulkowski, D.F. Gardiner, M. Rodríguez-Torres, K.R. Reddy, T. Hassanein, I. Jacobson, et al.
Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection.
N Engl J Med, 370 (2014), pp. 211-221

Please cite this article as: Auñón P, Morales E. Respuesta al comentario de «Infección por virus de la hepatitis C, interferón α y lupus, una curiosa asociación». Nefrologia. 2015;35:507–508.

Copyright © 2015. Sociedad Española de Nefrología
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Nefrología (English Edition)

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