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Published on: October 1, 2015
Thyroid dysfunction in a UK hepatitis C population treated with interferon-alpha and ribavirin combination therapy
Seán J Costelloe1, Nancy Wassef, Josephine Schulz
1Department of Clinical Biochemistry, The Royal Free Hampstead NHS Trust, Pond Street, London, United Kingdom.
Thyroid dysfunction (TD) is common during interferon-alpha and ribavirin therapy for hepatitis C virus (HCV). However, only a small percentage require long-term treatment, with baseline thyroid tests predicting risk.
Area of Science:
- Endocrinology
- Hepatology
- Pharmacology
Background:
- Hepatitis C virus (HCV) infection is a significant global health concern.
- Interferon-alpha and ribavirin combination therapy (IFN/RBV) has been a standard treatment for HCV.
- Thyroid dysfunction (TD) is a potential side effect of IFN/RBV therapy.
Purpose of the Study:
- To determine the incidence of thyroid dysfunction (TD) in patients with hepatitis C virus (HCV) treated with interferon-alpha and ribavirin (IFN/RBV).
- To identify predictors of TD development during IFN/RBV therapy.
Main Methods:
- Retrospective study of 288 patients receiving IFN/RBV for HCV.
- Thyroid function assessed during 24- or 48-week treatment courses.
- Thyroid isotope scans performed for undetectable TSH with elevated T4.
Main Results:
- 22.3% of patients developed TD during IFN/RBV therapy; women had a higher risk (RR 1.96).
- 10.4% developed suppressed TSH (including Graves' disease and transient thyroiditis), and 11.9% developed elevated TSH (1.5% permanent hypothyroidism).
- Pre-therapy TSH levels and thyroid peroxidase (TPO) antibody titres predicted TD progression (RR 6.02 and 4.35, respectively).
Conclusions:
- Thyroid dysfunction is a frequent complication of IFN/RBV therapy for HCV.
- Only a small proportion (2.3%) of patients required ongoing thyroid treatment.
- Baseline TSH and TPO antibody levels are valuable predictors for TD development during IFN/RBV treatment.
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