Thyroid abnormalities in chronic viral hepatitis and their relationship to interferon alfa therapy

Abstract

shimoto's disease, 1,2 as well as of thyroid autoantibodies and/ The prevalence of antithyroid peroxidase antibodies or thyroid dysfunction among patients with chronic hepatitis (ATPO) and/or of thyroid dysfunction was studied in 422 C. [3][4][5] However, the suggested link between hepatitis C and patients with chronic viral hepatitis C, B, and D. Baseline thyroid disease is still uncertain. Data in the literature are results were compared with those during and 6 months after few and differ widely among studies, depending on the charinterferon alfa (IFN-a) therapy. The overall prevalence of acteristics of the populations tested and the sensitivity of the ATPO among untreated patients was 14.1%, with no signifimethods used. [6][7][8] Moreover, in most reports, no comparison cant differences between chronic hepatitis C, B, or D, as well has been made between chronic hepatitis C and the other as between males and females. However, high ATPO titers known types of chronic viral hepatitis (B and D). (¢18 IU/mL) clustered significantly among females (8.7% vs.Therapy with interferon alfa (IFN-a), widely used in 3.4%; P Å .022), especially those with chronic hepatitis C chronic viral hepatitis B or C and in various malignant dis-(11.2% vs. 3.6%; P Å .036). Before treatment, 3.7% of the eases, has also been associated with a high prevalence of patients had thyroid dysfunction, mostly hypothyroidism autoantibodies, and rarely with the development of overt (3.5%), the latter increasing to 14.3% among patients with autoimmune diseases. Thyroid disease, with clinical manifes-ATPO titers ¢18 IU/mL. IFN-a treatment significantly intations of hypothyroidism or hyperthyroidism, has been recreased overall thyroid dysfunction (9.7%; P Å .001) and ported in 5% to 12% of patients who received IFN-a for hypothyroidism (7.8%; P Å .01), particularly among patients various diseases, 9-11 while antithyroid autoantibodies were with high baseline ATPO (38.5%; P Å .0002). Six months present in a high percentage. 11-14 Indeed, only a minority of after stopping IFN-a treatment, the prevalence of thyroid dyspatients with chronic viral hepatitis who are positive for function was 8.0%, still significantly higher than at baseline.antimicrosomal or antithyroid antibodies have thyroid dysBy multivariate analysis, the only predictor positively associfunction, which is usually subclinical. transcriptase polymerase chain reaction method (Amplicor, Roche

Comparison of adverse effects related to pegylated interferon-based therapy for patients with chronic hepatitis B and chronic hepatitis C in Taiwan

“…The incidence of thyroid dysfunction in our study (8.0-15.2%) seemed to be higher than the mean incidence (*6%; hyperthyroidism in 1%, hypothyroidism in 5%) indicated in a previous report [33]. Asian descent, female gender, positive pretreatment test for the presence of thyroid microsomal antibody, and age older than 60 are associated with an increased risk of thyroid dysfunction in patients with chronic HCV who receive IFN treatment [34,35].…”

Understudied populations with hepatitis C

“…Alpha interferon has been shown to induce autoantibodies in a high proportion of patients and to cause clinically apparent autoimmune disease in 1% to 2% of patients. [49][50][51][52] The most common form of autoimmunity induced by interferon is thyroiditis, which can result in either hypo-or hyperthyroidism. 50,51 Induction of thyroiditis is most frequent in patients with preexisting antibody to thyroid peroxidase (anti-TPO), which supports the concept that alpha interferon induces autoimmunity largely in patients with a pre-existing diathesis.…”

“…[49][50][51][52] The most common form of autoimmunity induced by interferon is thyroiditis, which can result in either hypo-or hyperthyroidism. 50,51 Induction of thyroiditis is most frequent in patients with preexisting antibody to thyroid peroxidase (anti-TPO), which supports the concept that alpha interferon induces autoimmunity largely in patients with a pre-existing diathesis. 52 Patients developing hypothyroidism during therapy can usually be continued on interferon therapy and managed with thyroid replacement.…”

Factors associated with treatment interruption for hepatitis C

“…14 Likewise, no association was found between sex and treatment interruption, corroborating the literature data. However, Deutsch M et al (1997) showed that certain adverse effects, more common among women, as the occurrence of hypothyroidism, may lead to cessation of therapy. 15 Combination therapy with INF + RBV or PEGINF + RBV is associated with side effects that can lead to dose reduction or treatment interruption.…”

“…However, Deutsch M et al (1997) showed that certain adverse effects, more common among women, as the occurrence of hypothyroidism, may lead to cessation of therapy. 15 Combination therapy with INF + RBV or PEGINF + RBV is associated with side effects that can lead to dose reduction or treatment interruption. 16 Our findings indicated no association between the type of therapy and treatment interruption.…”