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Autoimmunity and thyroid function in patients with chronic active hepatitis treated with recombinant interferon
D Preziati1, L La Rosa, G Covini
1Istituti di Scienze Endocrine, Medicina Interna-Malattie Infettive-Immunopatologia, Ospedale Maggiore IRCCS, Milan, Italy.
European Journal of Endocrinology
|May 1, 1995
Summary
Recombinant interferon alpha-2a (IFN-alpha) therapy for chronic hepatitis C (CAH-HCV) significantly increases thyroid abnormalities and autoantibodies. While IFN-alpha treatment also affects CAH-B patients, the impact on thyroid function is less pronounced.
Area of Science:
- Hepatology
- Immunology
- Endocrinology
Background:
- Chronic active hepatitis B and C (CAH-HBV and CAH-HCV) are common liver conditions.
- Long-term recombinant interferon alpha-2a (IFN-alpha) therapy is used for chronic viral hepatitis.
- Thyroid dysfunction and autoantibody development are potential side effects of medical treatments.
Purpose of the Study:
- To investigate the occurrence of thyroid abnormalities and autoantibodies in patients with CAH-HCV and CAH-HBV undergoing long-term IFN-alpha therapy.
- To assess the impact of IFN-alpha on pre-existing and newly developing thyroid autoantibodies and dysfunction.
Main Methods:
- Prospective study of 86 CAH-HCV and 51 CAH-HBV outpatients receiving long-term IFN-alpha therapy.
- Baseline and follow-up assessments included clinical evaluation, biochemical markers, and autoantibody testing (anti-thyroid, anti-nuclear, anti-parietal cell).
Main Results:
- At baseline, 9.3% of CAH-HCV and 3.9% of CAH-HBV patients had thyroid dysfunction. Anti-thyroid autoantibodies were present in 42.3% of CAH-HCV and 10.2% of CAH-HBV patients.
- During IFN-alpha treatment, anti-thyroid autoantibodies increased in 40% of CAH-HCV patients and induced hypothyroidism or hyperthyroidism in 34.3% of CAH-HCV patients treated for 12 months.
- Anti-nuclear autoantibodies (ANA) increased in CAH-HCV patients post-treatment (35.7%), and anti-parietal cell antibodies (PCA) appeared in both CAH-HCV and CAH-HBV patients, though no systemic autoimmune disease was observed.
Conclusions:
- Long-term IFN-alpha therapy is associated with a significant increase in thyroid abnormalities and autoantibodies, particularly in patients with CAH-HCV.
- While IFN-alpha can induce thyroid dysfunction and autoantibodies in CAH-HBV patients, the effect is less pronounced compared to CAH-HCV patients.
- Monitoring thyroid function and autoantibody status is crucial for patients receiving long-term IFN-alpha therapy for chronic viral hepatitis.