Central hypothyroidism in patients with chronic hepatitis C and relation with interferon-alpha treatment

Since some authors referred to panhypopituitarism or central hypothyroidism during the treatment of chronic hepatitis C virus (HCV) infection using interferon-α, it is intended to evaluate the prevalence of central hypothyroidism (CH) in HCV patients before and during interferon-α therapy.

We evaluated 308 HCV patients treated with standard interferon-α (IFN) and/or pegylated-interferon-α (PEG-IFN) associated with ribavirin. Free thyroxine (FT4) and thyrotropin (TSH) levels were measured before, during and after treatment. CH was diagnosed when the level of FT4 was lower than normal values with concomitant normal or lower TSH as verified at least in two consecutive measures.

Before treatment, 18 (5.8 %) patients presented CH Twelve patients maintained laboratory changes during the treatment and 17 new patients developed central hypothyroidism. Among the 29 patients (9.4 %) with CH, 11 used IFN, six used PEG-IFN and 12 patients used two or more therapeutic schedules. The differences in gender, age, cirrhosis, viral genotype, duration of treatment and the type of interferon used were not statistically significant. The absence of sustained virologic response was associated with central hypothyroidism (OR=3.83).

HCV patients may develop CH due to viral infection or during the interferon treatment. These patients presented 3.83 times more chance of not obtaining sustained virologic response.