Triggering of acute alcoholic hepatitis by α-interferon therapy

Background/Aims: Alcohol may induce autoimmunity by recognition of acetaldehyde-modified proteins which may be implicated in the pathogenicity of acute alcoholic hepatitis. We report here the potential role of α-interferon, a potent inducer of the autoimmunity process, in inducing alcoholic hepatitis. Methods: We analyzed clinical, biological, virological and histological features in two cases where α-interferon treatment for HCV-related hepatitis led to a marked increase in aminotransferase activities. Results: α-interferon as treatment of HCV-related hepatitis seemed to exacerbate acute alcoholic hepatitis despite moderate alcohol consumption. In Case 1, moderate daily alcohol intake of 40 g during therapy led to biopsy-proven acute alcoholic hepatitis, while the same consumption before therapy did not. In Case 2, before treatment, the liver biopsy showed mild acute alcoholic hepatitis; aminotransferases increased during α-interferon therapy, although no increase in alcohol intake was observed. Conclusion: α-interferon therapy by its immunomodulatory properties could be implicated in alteration of the course of acute alcoholic hepatitis. These observations emphasize that the decision to treat with α-interferon when there is even moderate alcohol consumption should be carefully weighed in HCV-infected patients