Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity

Area of Science:

• Hepatology
• Endocrinology
• Virology

Background:

• Interferon-alfa (IFN-α) therapy for Hepatitis C Virus (HCV) is known to cause thyroid alterations.
• The impact of newer direct-acting antivirals (DAAs) on thyroid health remains largely unestablished.

Purpose of the Study:

• To prospectively evaluate the effect of DAAs on thyroid function and autoimmunity in HCV patients.
• To compare thyroid outcomes between treatment-naïve patients and those previously treated with IFN-α.

Main Methods:

• 113 HCV patients were assessed: 64 treatment-naïve and 49 previously treated with IFN-α.
• Thyroid function and autoimmunity were evaluated before and after 20-32 weeks of DAAs therapy.
• Patients were monitored for Hashimoto's thyroiditis, hypothyroidism, and hyperthyroidism.

Main Results:

• No new cases of Hashimoto's thyroiditis, hypothyroidism, or hyperthyroidism were observed after DAAs treatment.
• A significant proportion (54.5%) of patients with pre-existing subclinical non-autoimmune thyroid dysfunction normalized thyroid function post-DAAs.
• HCV genotype 1 was associated with hypothyroidism.

Conclusions:

• DAAs demonstrate a limited or negligible impact on thyroid function in HCV patients.
• DAA therapy may lead to improvement in subclinical non-autoimmune thyroid dysfunction following successful HCV eradication.