Thyroid dysfunction (TD) among chronic hepatitis C patients with mild and severe hepatic fibrosis.
BACKGROUND
Thyroid dysfunction (TD) is associated to chronic hepatitis C (HCV) and interferon (IFN) therapy. The prevalence of TD at baseline and during IFN therapy among stages of hepatic fibrosis is unknown.


OBJECTIVE
To examine the frequency of TD at baseline and during Peg-IFN therapy among patients with severe and mild fibrosis.


METHODS
100 patients were treated with Peg-IFN and divided in 2 groups (50 each), according to liver histology; Metavir 0-2 (mild fibrosis) and Metavir 3-4 (severe fibrosis). Baseline TD was defined as history of TD, or abnormal thyroid stimulating hormone (TSH) or antiperoxidase thyroid auto-antibodies (TPO -Ab). Frequency of TD during therapy was defined as TD that required treatment.


RESULTS
20% in the severe fibrosis group and 10% in the mild fibrosis group, had TD at baseline. Most of the cases, 31.4% were female as compared to 6.25% males. During therapy, 24% of patients in the severe fibrosis group, compared to 12% in the mild fibrosis, had TD. Most patients had biochemical hypothyroidism, and 66% were female, compared to 33.33 % male. TPO-Ab predicted TD during therapy in 50% of cases while those negative only had 16.6% TD during IFN therapy.


CONCLUSIONS
Patients with severe fibrosis have more TD events at baseline and during treatment with Peg IFN alfa-2a. Patients with more hepatic fibrosis require careful attention to diagnose and manage TD. More research in the immune mechanisms of hepatic fibrosis progression and autoimmune complications is needed.
Rodríguez-Torres
Maribel
M
Fundación de Investigación de Diego, San Juan, PR. rodztorres@coqui.net
Ríos-Bedoya
Carlos F
CF
Ortiz-Lasanta
Grisell
G
Marxuach-Cuétara
Acisclo M
AM
Jiménez-Rivera
Josselyn
J
D000998:Antiviral Agents / Q000009:adverse effects; D015415:Biomarkers; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects; D015995:Prevalence; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D017678:Sex Distribution; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology / Q000276:immunology / Q000821:virology*
D000998:Antiviral Agents; D015415:Biomarkers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a