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Thyroid dysfunction in patients with chronic hepatitis C: virus- or therapy-related?
Elena Vezali1, Ioannis Elefsiniotis, Constantinos Mihas
1University Department of Internal Medicine, Hepatology Unit, Elena Venizelou Hospital, Athens, Greece. avezalis@otenet.gr
Journal of Gastroenterology and Hepatology
|April 23, 2009
Summary
Antiviral therapy for chronic hepatitis C (CHC) may cause thyroid dysfunction (TD) in patients. This TD is not linked to viral factors but may be associated with other autoimmune disorders developing during treatment.
Area of Science:
- Hepatology
- Endocrinology
- Clinical Medicine
Background:
- Thyroid dysfunction (TD) is an extrahepatic manifestation of chronic hepatitis C (CHC).
- Current CHC treatments are associated with TD, but its cause (viral vs. treatment) is debated.
Purpose of the Study:
- To assess the incidence and features of TD in CHC patients.
- To identify predictors of TD in treated and untreated CHC patients.
Main Methods:
- 94 CHC patients with normal thyroid function were followed long-term.
- 33 untreated (control) and 61 treated with pegylated interferon alpha (PEG-IFN-alpha) plus ribavirin.
Main Results:
- 21.3% of treated patients developed TD (hypothyroidism or hyperthyroidism), versus 0% in controls (P < 0.001).
- TD often persisted after treatment cessation and required hormone replacement.
- TD was not predicted by pretreatment viral parameters, treatment dose, duration, viral kinetics, or outcome, but was linked to other autoimmune disorders (OR, 8.29).
Conclusions:
- Antiviral therapy for CHC may induce or worsen TD.
- TD is likely not related to viral factors, treatment specifics, or virological outcomes.
- The role of CHC itself in TD requires further investigation.
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