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By promoting beta\u2010cell, thyroid, and systemic immune injury, it can lead to Type 1 diabetes, autoimmune thyroiditis, systemic lupus erythematosus, or Sj\u00f6gren's syndrome. Onset typically occurs within the first months but may be delayed until after treatment cessation. Type 1 diabetes is usually irreversible and requires lifelong therapy, whereas thyroiditis and lupus more often improve after interferon withdrawal, though autoantibodies frequently persist. In this narrative review, we provide an overview of how peginterferon can induce autoimmunity in genetically susceptible individuals with pre\u2010existing subclinical autoimmunity. Pre\u2010treatment risk assessment, including personal\/family history of autoimmune disease and consideration of baseline thyroid function and anti\u2010GAD antibodies in high\u2010risk patients, may identify those at elevated risk for irreversible complications, particularly Type 1 diabetes. Targeted clinical and laboratory monitoring throughout therapy and for 12\u201324 months post\u2010cessation can enable early detection and appropriate intervention.<\/jats:p>","DOI":"10.1002\/hem3.70432","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:55:20Z","timestamp":1784199320000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Autoimmunity and peginterferon therapy for polycythemia vera"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0254-3394","authenticated-orcid":false,"given":"Etienne","family":"Rivi\u00e8re","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Haut\u2010Leveque Hospital University Hospital of Bordeaux Pessac France"},{"name":"INSERM U1034 University of Bordeaux Pessac 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