Thyroid function and anti-thyroid autoantibodies in untreated children with vertically acquired chronic hepatitis C virus infection.
OBJECTIVE
The reported data on thyroid function and anti-thyroid autoantibodies in adults with untreated hepatitis C virus (HCV) infection are controversial. Data are scarce for HCV-infected children, and only in those treated with interferon-alpha (IFN-alpha). We investigated thyroid function and anti-thyroid autoantibodies in a cohort of untreated children with vertically acquired, chronic, HCV infection.


METHODS
FT4 and TSH serum levels (measured by immunometric assays) and anti-thyroglobulin (TgA) and anti-thyroperoxidase (TPOA) antibodies (evaluated by fluorescence enzymatic immunoassays) were studied in 36 consecutive HCV-infected children and 150 age- and sex-matched controls. The prevalence of thyroid involvement was also related to family history of autoimmune disease, distribution of HCV genotypes, and duration and activity of HCV infection.


RESULTS
Four out of 36 (11.1%) HCV-infected children and 4/150 controls (2.7%) showed subclinical hypothyroidism [P = 0.04; relative risk (RR) 4.56, 95% confidence interval (CI) 1.08-19.21]. None of these had anti-thyroid autoantibodies. Two out of 36 (5.6%) HCV-infected children and 1/150 (0.7%) controls had increased TgA values with normal levels of TSH (P > 0.05). Subclinical hypothyroidism and anti-thyroid autoantibodies were not related to family history of autoimmune disease, duration of infection, HCV viral load, liver function or different HCV genotype distribution, but seemed to be related to the presence of active HCV infection.


CONCLUSIONS
Our data suggest a role for HCV infection in the development of nonautoimmune thyroid disease in untreated HCV-infected children, confirming previous studies in adults. Clinicians should be aware of thyroid dysfunction even in untreated children.
Indolfi
Giuseppe
G
Department of Paediatrics, University of Florence, Anna Meyer Children's Hospital, Florence, Italy. g.indolfi@meyer.it
Stagi
Stefano
S
Bartolini
Elisa
E
Salti
Roberto
R
de Martino
Maurizio
M
Azzari
Chiara
C
Resti
Massimo
M
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000276:immunology* / Q000503:physiopathology*; D006801:Humans; D007118:Immunoassay; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D013959:Thyroid Diseases / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D013961:Thyroid Gland / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
D001323:Autoantibodies; C006606:anti-thyroglobulin; D013972:Thyrotropin; D013974:Thyroxine