Evolution and predictive factors of thyroid disorder due to interferon alpha in the treatment of hepatitis C.
OBJECTIVE
To study predictive factors of thyroid dysfunction associated with interferon-alpha (IFNalpha) therapy in chronic hepatitis C (CHC) and to describe its long-term evolution in a large population without previous thyroid dysfunction.


METHODS
We performed a follow-up of thyroid function and detection of thyroid antibodies in 301 patients treated for CHC with IFNalpha from 1999 to 2004.


RESULTS
Thyroid disorder developed in 30/301 (10%) patients with a mean delay of 6 +/- 3.75 mo: 13 patients had hyperthyroidism, 11 had hypothyroidism, and 6 had biphasic evolution. During a mean follow-up of 41.59 +/- 15.39 mo, 9 patients with hyperthyroidism, 3 with hypothyroidism, and 4 with biphasic evolution normalized thyroid function in 7.88 +/- 5.46 mo. Recovery rate of dysthyroidism was not modified by treatment discontinuation, but was better for patients with negative thyroid antibodies before antiviral treatment (P = 0.02). Women had significantly more dysthyroidism (P = 0.05). Positive thyroid peroxidase and thyroglobulin antibodies were more frequent before antiviral treatment in patients who developed dysthyroidism (P < 0.0003 and P = 0.0003, respectively). In a multivariate model, low fibrosis was found to be a predictive factor of dysthyroidism (P = 0.039).


CONCLUSIONS
In this monocentric population of CHC, dysthyroidism, especially hyperthyroidism, developed in 10% of patients. Low fibrosis was found to be a predictive factor of dysthyroidism. Thyroid disorder recovered in 16/30 patients (53%) and recovery was better in the non-autoimmune form.
Gelu-Simeon
Moana
M
Department of Hepatology and Gastroenterology, Bicetre Hospital, Le Kremlin-Bicetre, France. moana.gelu@chu-guadeloupe.fr
Burlaud
Aurore
A
Young
Jacques
J
Pelletier
Gilles
G
Buffet
Catherine
C
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013959:Thyroid Diseases / Q000139:chemically induced* / Q000145:classification / Q000473:pathology
D000998:Antiviral Agents; D001323:Autoantibodies; D016898:Interferon-alpha