albeit with different prevalences, and a third report suggests The most effective treatment of chronic hepatitis B that IFN-a may be a trigger for autoimmune hepatitis. 13 To virus (HBV) infection is interferon alfa (IFN-a), a potenaddress the question as to whether any clinical or serological tially severe side effect of which is the induction of autosigns of autoimmune liver disease are induced by IFN-a immunity. To assess whether IFN-a causes clinical or treatment, we have followed up 61 children participating in serological autoimmune manifestations, we studied 61 a multicenter, randomized, controlled trial, including a group children randomized to receive 5 MU/m 2 of IFN-a three of untreated patients, for a median of 4 years, and we have times per week for 12 weeks, with or without steroid analyzed the prevalence of tissue autoantibodies in 331 of priming or no treatment. Autoantibodies to antinuclei their sera collected over this period. (ANA), smooth muscle (SMA), gastric parietal cell (GPC), liver kidney microsomal type 1, mitochondrial, liver cy-PATIENTS AND METHODS tosolic antigen, thyroid microsomal, and thyroid globulin were detected by standard techniques. Over a me-Of 106 children with chronic HBV infection enrolled in a threedian of 4 years (range, 1-5 years) from randomization, arm randomized, controlled trial, 61 children (median age, 9 years no clinical signs of autoimmunity were observed. Auto-[range, 2-16 years]; 33 boys) with sufficient stored sera collected over antibody positivity for nuclei, smooth muscle, and/or a period of 1 to 5 years (median, 4 years) for subsequent serial analy- sis were investigated. Before randomization, all patients were (1) gastric parietal cells was observed on at least one occa-HBV-DNA-positive (by dot-blot hybridization technique) 14 on at sion in 42 of 61 children (69%), with no overall difference least two occasions taken 1 month apart and hepatitis B e antigenin the prevalence between patients treated with interpositive (by microparticle enzyme immunoassay, Abbott, Chicago, feron alone (19 of 24 [79%]), steroids plus interferon (13 IL) for at least 1 year; (2) negative for antibodies to hepatitis D (by Abbreviations: IFN-a, interferon alfa; HBV, hepatitis B virus; ANA, antinuclear antiization (representing the 6th to 12th week of IFN-a treatment in body; SMA, smooth muscle antibody; GPC, gastric parietal cell; IgG, immunoglobulin G; patients in groups A and B), and from 8 to 24 months (median, 19 IgM, immunoglobulin M. months) after randomization (representing the 3rd to 20th month From the Departments of