title: Risk factors and long-term course of thyroid dysfunction during antiviral treatments in 221 patients with chronic hepatitis C.
abstract: OBJECTIVE
  To identify the predictive factors of dysthyroidism during treatment for chronic viral hepatitis C and to evaluate the long-term outcome of these patients.
  
  
  METHODS
  Patients treated for chronic viral hepatitis C between 1990 and 2001 were analyzed retrospectively. Patients with dysthyroidism before treatment and patients positive for hepatitis B surface antigen or human immunodeficiency virus antibodies were excluded. Dysthyroidism was defined by an abnormal serum TSH level on two separate occasions.
  
  
  RESULTS
  221 consecutive patients were included. Among them, a hundred were treated twice by interferon alpha, 21 had 3 treatments and 3 had 4 treatments. Fifteen of these patients (7%) had dysthyroidism during antiviral therapy. There was no significant difference in the frequency of dysthyroidism during the first and the second treatment [respectively 4,1% (N = 9) and 6% (N = 6)]. Female gender and the presence of antimicrosome or antithyroperoxydase (anti-TPO) antibodies before antiviral treatment were predictive factors of dysthyroidism. Treatment by interferon and ribavirin did not increase the risk of dysthyroidism compared to monotherapy with interferon. Pegylated interferon (N = 49) was not a risk factor compared to standard interferon. Thirteen patients had hypothyroidism (2 of them as a result of biphasic thyroiditis) and 2 had hyperthyroidism. The antiviral treatment was continued in 11 patients. Seven out of 13 patients with hypothyroidism required an indefinite treatment (follow-up: 15 to 90 months).
  
  
  CONCLUSIONS
  In our series, 7% of patients with chronic viral hepatitis C had a dysthyroidism during antiviral therapy. Predictive factors were female gender and positive antimicrosome or anti-TPO antibodies before treatment. Absence of dysthyroidism during a first antiviral treatment did not preclude from the risk of dysthyroidism during a second treatment.
authors.affiliation: Service d'Hépato-Gastroentérologie, CHU Robert Debré, Reims, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Moncoucy
authors.forename: Florence
authors.initials: F
authors.lastname: Leymarie
authors.forename: Brigitte
authors.initials: B
authors.lastname: Delemer
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lévy
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bernard-Chabert
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouché
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Marie-Danièle
authors.initials: MD
authors.lastname: Diebold
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiéfin
mesh_terms: D000328:Adult; D000917:Antibody Formation; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013959:Thyroid Diseases / Q000139:chemically induced*
chemical_list: D000998:Antiviral Agents