Frequency of Thyroid Dysfunctions during Interferon Alpha Treatment of Single and Combination Therapy in Hepatitis C Virus-Infected Patients: A Systematic Review Based Analysis

Background:Hepatitis C virus (HCV) infection is common worldwide. The treatment typically involves a combination of interferon-alpha (IFN-α) and ribavirin (RBV) therapy; however, the use of IFN-α is well documented to be associated with thyroid disease, the most common autoimmune disorder associated with IFN-α.Aim:The aim of the present study was to know the prevalence of thyroid abnormality in the HCV-positive patients on IFN and antiviral therapy.Materials and Methods:Fifty known HCV positive patients were enrolled for the study. All the patients were on IFN (3 million unit subcutaneously 3 times/week) and antiviral therapy (oral RBV 1000–1200 mg/day). Thyroid function tests were performed first at the start of treatment and then after 12 weeks of treatment.Results:13 (26%) of the patients were found to develop hypothyroidism, and 1 (2%) patient developed hyperthyroidism in the course of 12 weeks therapy.Conclusion:HCV patients on IFN and antiviral therapy have an effect on the thyroid gland, so these patients should be regularly screened for thyroid disorders and appropriately treated to maintain euthyroid status.

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“…IFN a therapy alone or in combination with other drugs has different effects on the incidence of thyroid dysfunctions. [19]…”

Section: Discussionmentioning

confidence: 99%

Prevalence of thyroid disorders in hepatitis C virus positive patients on interferon and antiviral therapy

Goyal

Panag

Garg

2016

Int J App Basic Med Res

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“…Second, reducing IFN signaling in an early mouse model of DS (Ts16) with either anti-IFN antibodies or by crossbreeding with a mouse strain lacking two IFNRs improved embryonic development and increased survival of cortical neurons in vitro (Maroun 1995; Hallam and Maroun 1998; Maroun et al 2000). Third, long-term administration of IFN ligands for the treatment of diverse medical conditions, such as multiple sclerosis or chronic viral infections, is known to produce several undesirable side effects, many of which resemble DS-associated co-morbidities, including wide-ranging psychiatric side-effects (Kovacs et al 2016), depression (Kovacs et al 2016; Lucaciu and Dumitrascu 2015), pulmonary hypertension (Savale et al 2016), autoimmune hypothyroidism (Nair Kesavachandran et al 2013), and cardiotoxicity (Sonnenblick and Rosin 1991). Finally, a recent report of a segmental duplication of a region containing only 18 genes of Hsa21, including the four IFNRs, indicates that triplication of this small genomic region was sufficient to produce the developmental hallmarks of DS in the absence of complete T21 (Weisfeld-Adams et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Exosomal biomarkers in Down syndrome and Alzheimer's disease

Hamlett

Ledreux

Potter³

et al. 2018

Free Radical Biology and Medicine

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Every person with Down syndrome (DS) has the characteristic features of Alzheimer’s disease (AD) neuropathology in their brain by the age of forty, and most go on to develop AD dementia. Since people with DS show highly variable levels of baseline function, it is often difficult to identify early signs of dementia in this population. The discovery of blood biomarkers predictive of dementia onset and/or progression in DS is critical for developing effective clinical diagnostics. Our recent studies show that neuron-derived exosomes, which are small extracellular vesicles secreted by most cells in the body, contain elevated levels of amyloid-beta peptides and phosphorylated-Tau that could indicate a preclinical AD phase in people with DS starting in childhood. We also found that the relative levels of these biomarkers were altered following dementia onset. Exosome release and signaling are dependent on cellular redox homeostasis as well as on inflammatory processes, and exosomes may be involved in the immune response, suggesting a dual role as both triggers of inflammation in the brain and propagators of inflammatory signals between brain regions. Based on recently reported connections between inflammatory processes and exosome release, the elevated neuroinflammatory state observed in people with DS may affect exosomal AD biomarkers. Herein, we discuss findings from studies of people with DS, people with DS and AD (DS-AD), and mouse models of DS showing new connections between neuroinflammatory pathways, oxidative stress, exosomes, and exosome-mediated signaling, which may inform future AD diagnostics, preventions, and treatments in the DS population as well as in the general population.

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“…Hashimoto's thyroiditis (HT) is the most common thyroid disorder observed in patients with HCV infection. IFN-α therapy is associated with development of thyroid dysfunction in chronic hepatitis C (CHC) patients, usually exposing preexisting subclinical thyroid abnormalities [2]. The prevalence of anti-thyroid antibodies (anti-thyroid peroxidase antibody, TPOAb; anti-thyroglobulin antibody, TGAb; anti-thyroid microsomal antibody, ATMA) varied markedly, from 2% to 48% in IFN-α treated CHC patients [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Shen

Wang

Xie

et al. 2016

JGLD

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Background & Aims: The involvement of thyroid autoimmunity and dysfunction in patients with chronichepatitis C virus (HCV) infection before interferon-α (IFN-α) therapy remains controversial. We performedthis meta-analysis to evaluate the association of HCV infection with the presence of anti-thyroid antibodiesand dysthyroidism. Methods: A literature search was carried out to collect articles dated up to August 2015 to identify observationalstudies which compared the prevalence of anti-thyroid antibodies and thyroid dysfunction in IFN-α naïvechronic HCV-infected subjects with non-HCV infected controls. Random-effect or fixed-effect meta-analyseswere applied and results reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Twelve studies were included, involving 1,735 HCV-infected and 1,868 non-HCV infected subjects.Pooled anti-thyroid antibody prevalence tended to be higher in HCV-infected subjects. The prevalence ofanti-thyroglobulin antibody (TGAb), anti-thyroid peroxidase antibody (TPOAb), anti-thyroid microsomalantibody (ATMA) were 2.40-fold, 1.96-fold and 1.86-fold higher in HCV-infected subjects than in controls,respectively. The prevalence of hypothyroidism also differed by HCV infection status, with a pooled risk of3.10 (95%CI: 2.19-4.40) in HCV-infected subjects. However, the results did not show a significant differencein the prevalence of hyperthyroidism between the two groups.Conclusion: Chronic HCV infection may be an independent risk factor for thyroid disturbance. It is advisablefor the clinicians to monitor both thyroid antibodies and function in the course of chronic HCV infection,independent of IFN-α treatment. Abbreviations: AITD: autoimmune thyroid disease; ATMA: anti-thyroid microsomal antibody; CHC:chronic hepatitis; GD: Graves’ disease; HCV: hepatitis C virus; HT: Hashimoto’s thyroiditis; IFN-α: interferonalpha;NOS: Newcastle-Ottawa quality assessment scale; T3: triiodothyronine; T4: thyroxine; TGAb: antithyroglobulinantibody; TPOAb: anti-thyroid peroxidase antibody.

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Frequency of Thyroid Dysfunctions during Interferon Alpha Treatment of Single and Combination Therapy in Hepatitis C Virus-Infected Patients: A Systematic Review Based Analysis

Cited by 27 publications

References 65 publications

Prevalence of thyroid disorders in hepatitis C virus positive patients on interferon and antiviral therapy

Prevalence of thyroid disorders in hepatitis C virus positive patients on interferon and antiviral therapy

Exosomal biomarkers in Down syndrome and Alzheimer's disease

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

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