Role of Chronic Viral Hepatitis B and C as Risk Factors for Celiac Disease

Abstract

Aims: Celiac disease (CD) is an autoimmune disease and hepatitis B virus (HBV) is suspected to trigger immunologic gluten intolerance in susceptible individuals. The aim of this study is to assess the role of chronic HBV and HCV infection in adult patients as risk factors of celiac disease. Study Design: Case-control study. Place and Duration of Study: Department of Medical Microbiology and Immunology and Department of Clinical Pathology, College of Medicine, Qassim University, between September 2012 and November 2014. Methodology: This study included 30 chronic HBV patients and 30 chronic HCV patients, thirty normal individuals were included as controls. Anti-tissue transglutaminase (Anti-tTG) IgA was assessed in the three groups, non-organ specific autoantibodies (NOSA) including antimitochondrial (AMA), antinuclear (ANA) and anti-smooth muscle (ASMA) antibodies were also assessed. Results: Anti-tTG IgA revealed significantly higher levels in both HBV (mean = 41.72, SE = 1.70) and HCV (mean = 46.93, SE = 5.46) groups compared to the controls (mean = 29.60, SE = 1.27), (P = .01, < .001 respectively). The positivity of ASMA was significantly higher in HBV patients than in the controls (46.7%, 16.7%, P = .01). ANA and AMA showed insignificant difference between the three groups. Conclusion: The higher levels of anti-tTG autoantibodies in adult patients with chronic HBV and HCV infections reflect higher incidence to develop CD than normal population. Screening for CD in such patients is recommended.