Autoimmune thyroid disorders in hepatitis C virus infection: Effect of interferon therapy

Jadali, Zohreh

doi:10.4103/2230-8210.107856

Cited by 26 publications

(16 citation statements)

References 70 publications

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“…Different studies have proposed several mechanisms for induction of autoimmune thyroiditis by HCV infection like molecular mimicry between viral antigens and self-antigens, activation of autoreactive T cells (bystander mechanism) by induction of local inflammation, induction of aberrant expression of MHC class II molecules on thyroid cells, viral induction of changes in self-antigen expression of cryptic epitopes, and induction of heat-shock proteins in the thyroid [ 4 , 25 , 26 ]. On the other hand, the HCV inducing the thyroid autoimmunity in predisposed individual are still mysterious.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Peroxidase Antibodies in Non-Interferon Treated Hepatitis C Patients in Pakistan

Shafiq

Gauhar

Akram

et al. 2015

BioMed Research International

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Objective. Interferon therapy of HCV infected patients is associated with development of thyroid dysfunctions. Patients with pretreatment presence of antithyroid peroxidase (TPO-Ab) are at greater risk. This study, probably the first in Pakistan, was planned to determine TPO-Ab in sera of treatment-naive local HCV patients. Setting. Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore. Patients and Methods. During July to December 2012, 190 patients (140 females, 50 males) newly diagnosed for HCV infection were selected for this study. Their age range was 15–55 years (mean: 35.3 ± 9.1 years). 262 age matched healthy subjects (211 females and 50 males) were recruited as control. Serum-free thyroxin (FT4) and thyroid stimulating hormone (TSH) were detected by radioimmunoassay techniques. Serum TPO-Ab titer was determined by ELISA method using commercial kits. Results. Serum FT4 and TSH levels in HCV patients and controls were within normal range. Between two groups there was no significant difference in mean value of FT4 (16.0 ± 3.0 versus 16.2 ± 3.9; P = 0.619) but mean TSH value was significantly lower in HCV patients (1.5 ± 0.8 versus 1.8 ± 0.9; P = 0.003). Among HCV patients 51 (26.8%) were TPO-Ab positive and among control subjects 18 (6.9%) were TPO-Ab positive. The difference was statistically significant (P < 0.001). Further analysis showed that among HCV patients 39 (27.8%) females and 12 (24.0%) males were TPO-Ab positive, respectively, and difference was not statistically significant (P = 0.873). Moreover, TPO-Ab positive patients were older and had significantly higher serum TSH as compared to TPO-Ab negative HCV patients. Conclusion. Independent of patient's gender and increasing with advancing age, about one-fourth of local untreated HCV patients are TPO-Ab positive and are at greater risk of developing thyroid disorders during and after interferon treatment.

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Section: Discussionmentioning

confidence: 99%

Thyroid Peroxidase Antibodies in Non-Interferon Treated Hepatitis C Patients in Pakistan

Shafiq

Gauhar

Akram

et al. 2015

BioMed Research International

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“…In addition to its hepatic manifestations, CHC infection is associated with extrahepatic manifestations occurring in multiple organ systems, including the hematologic, renal, dermatologic, endocrine and rheumatologic systems. Among the endocrine disorders, thyroid disorders are the most common and the thyroid is one of the principal target organs for extrahepatic manifestations in HCV-infected patients [4]. The liver plays an important role in the metabolism of THS, as it is the most important organ in the peripheral conversion of tetraiodothyronine (T4) to triiodothyronine (T3) by type 1 deiodinase [2] [5].…”

Section: Introductionmentioning

confidence: 99%

Serum Level of Thyroid Hormones in Patients with Chronic Hepatitis C Virus Infection

Elfeki

Abdalla

Atta

et al. 2016

OJEMD

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Objective: There are clinical and laboratory associations between thyroid and liver diseases. Hepatitis C virus (HCV) is known to be responsible for both hepatic and extrahepatic diseases. The most frequent and clinically important endocrine extrahepatic diseases are thyroid disorders and type 2 diabetes mellitus. We aim to study the relationship between the serum level of thyroid hormones (THs) and the severity of liver disease in patients with chronic hepatitis C virus (CHC) infection. Methods: 60 patients with CHC infection were selected for the study. They were divided into two groups: with or without liver cirrhosis. Those with liver cirrhosis were further subdivided according to the Child-Turcotte-Pugh scoring system. Serum levels of free T3 (FT3), free T4 (FT4) and TSH were measured to all patients. Results: There was decrease in the FT3 and FT4 levels and increase in the TSH levels in patients with CHC with cirrhosis when compared to patients with CHC without cirrhosis. Conclusion: Thyroid profile abnormalities were seen in cirrhotic HCV patients when compared to non-cirrhotic patients. The abnormalities in the serum level of THs (decreased FT3, FT4, and increased TSH) are strongly associated with the severity of liver damage and advancing of the child score.

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“…Rituximab monotherapy effectively alleviated MC symptoms in about 71.4%84% HCV patients [111,112] . Rituximab given in combination peg IFNaribavirin was evaluated in patients with severe HCVcryo, resistant to IFNa combination therapy.…”

Section: Antiviral Treatmentmentioning

confidence: 99%

“…Rituximab mono therapy is thus highly relevant in treating cryovas emergencies such as neuropathic pain [111] . However its sole efficacy in reducing PN has not been satisfactorily assessed.…”

Section: Antiviral Treatmentmentioning

confidence: 99%

Hepatitis C virus and neurological damage

Mathew

Faheem

Ibrahim

et al. 2016

WJH

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Author contributions: Mathew S and Faheem M contributed equally to this manuscript; Qadri I conceived and designed the topic; Mathew S, Faheem M, Ibrahim SM, Iqbal W and Rauff B contributed to materials and wrote the paper; Faheem M, Ibrahim SM, Iqbal W, Rauff B, Fatima K and Qadri I contributed to proof reading of the manuscript.Supported by KACST large R and D grant to Ishtiaq Qadri (#162-34).Conflict-of-interest statement: Authors declare no conflict of interests for this article. AbstractChronic hepatitis C virus (HCV) infection exhibits a wide range of extrahepatic complications, affecting various organs in the human body. Numerous HCV patients suffer neurological manifestations, ranging from cognitive impairment to peripheral neuropathy. Overexpression of the host immune response leads to the production of immune complexes, cryoglobulins, as well as autoantibodies, which is a major pathogenic mechanism responsible for nervous system dysfunction. Alternatively circulating inflammatory cytokines and chemokines and HCV replication in neurons is another factor that severely affects the nervous system. Furthermore, HCV infection causes both sensory and motor peripheral neuropathy in the mixed cryoglobulinemia as well as known as an important risk aspect for stroke. These extrahepatic manifestations are the reason behind underlying hepatic encephalopathy and chronic liver disease. The brain is an apt location for HCV replication, where the HCV virus may directly wield neurotoxicity. Other mechanisms that takes place by chronic HCV infection due the pathogenesis of neuropsychiatric disorders includes derangement of metabolic pathways of infected cells, autoimmune disorders, systemic or cerebral inflammation and alterations in neurotransmitter circuits. HCV and its pathogenic role is suggested by enhancement of psychiatric and neurological symptoms in patients attaining a sustained virologic response followed by treatment with interferon; however, further studies are required to fully assess the impact of HCV infection and its specific antiviral targets associated with neuropsychiatric disorders. REVIEWSubmit a

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Autoimmune thyroid disorders in hepatitis C virus infection: Effect of interferon therapy

Cited by 26 publications

References 70 publications

Thyroid Peroxidase Antibodies in Non-Interferon Treated Hepatitis C Patients in Pakistan

Thyroid Peroxidase Antibodies in Non-Interferon Treated Hepatitis C Patients in Pakistan

Serum Level of Thyroid Hormones in Patients with Chronic Hepatitis C Virus Infection

Hepatitis C virus and neurological damage

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