Anti-HCV-positive subjects have decreased HRQOL compared to controls. The magnitude of this decrease was clinically important for the SF-36 vitality score. Host and environmental, rather than viral factors, seem to impact on HRQOL level.

SUMMARYInterferon alpha (IFN-a) therapy is associated with a number of immunological side-effects, including autoimmune diseases and a 10% prevalence of thyroiditis. Hepatitis C virus (HCV ) infection itself predisposes to autoimmune phenomena including hypothyroidism and myositis. The development of clinical hypothyroidism in the presence of positive thyroid antibodies in patients infected with HCV and treated with IFN-a suggests a possible association between the viral disease and the therapy. HCV infection may predispose to autoimmune thyroid disease and IFN-a therapy may secondarily lead to the development of thyroid dysfunctions. We report the single case of a female patient who developed a severe proximal myopathy in conjunction with primary hypothyroidism (Hoffmann's syndrome) secondarily to IFN-a therapy for HCV infection. This case highlights the need for careful clinical and biological monitoring for potential side-effects in such patients. Laboratory tests showed a normal white blood cell count <41]. Ten years previously, she suffered from jaundice which and erythrocyte sedimentation rate. The C-reactive protein was attributed to HCV infection, although there was no was <6 mg/l (normal: <10), and renal function tests were serological proof for this. Further investigations included normal. Liver function tests revealed a high SGOT of 96 virological tests which confirmed the diagnosis of active HCV [normal range (NR) 9-32 IU/l ] and a normal SGPT. Serum infection (positive HCV RNA in serum and anti-HCV muscle enzymes revealed an increased level of creatine phosantibody) and a liver biopsy which revealed chronic aggresphokinase (CPK ) of 2398 IU/l (NR 25-140), increased sive hepatitis with moderate lobular destruction and periportal aldolase of 11.5 (normal: <7.8). Immunological investilymphoid follicles. Autoantibody screen [antinuclear antibodgations showed the absence of ANA and anti-DNA antibodies, normal C3 and C4 levels, and the presence of antiperoxidase antibodies ( TPO-Ab) of 340 kU/l (normal:

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