Thyroid disorders and occurrence of nonorgan-specific autoantibodies (NOSA) in patients with chronic hepatitis C before and during antiviral induction therapy with consensus interferon (interferon alfacon-1).
OBJECTIVE
Thyroid disorders represent a common side effect of antiviral therapy in patients with chronic hepatitis C (CHC). However, there is strong evidence for a higher prevalence of thyroidal antibodies (TA) and nonorgan-specific autoantibodies (NOSA) even before interferon (IFN) administration. Here, we report for the first time on the distribution and occurrence of TA and NOSA before, during, and after treatment with daily highdosed IFN alfacon-1 [consensus IFN (CIFN)].


METHODS
Thyrotropin (TSH) levels and antibodies to different autoantigens were analyzed in 217 patients with CHC (29.8% females) who were treated with CIFN induction therapy (27 or 18 mg q.d.).


RESULTS
Pretreatment abnormal TSH levels (TSH>3.0 mU/L or <0.4 mU/L) were detected in 15.6% and occurred significantly more often in females (24.6%; P=0.018). TA could be detected only in 2.6%, NOSA in up to 29.9% (47.4% females vs. 24.2% males). During CIFN induction therapy, low TSH levels were detected in 14.1% whereas elevated TSH levels occurred later (week 48) in up to 15.5%, again preferentially in females (42%, P=0.005). In 1.4% of all patients, treatment had to be discontinued because of symptomatic hyperthyroidism. TAs were detected in 10.5% (30.5% females) and NOSA up to 58% during CIFN treatment.


CONCLUSIONS
During CIFN induction therapy, alterations in TSH levels and an increased prevalence of TA and NOSA are quite common, especially in females. Clinically relevant symptoms occur, however, only in a small number (1.4%). Thus, treatment with daily and high-dose CIFN does not appear to increase the incidence of (severe) thyroidal or other autoimmune disorders compared with standard IFN in patients with CHC.
Hass
Holger G
HG
Department of Internal Medicine III, Marienhospital, Stuttgart, Germany. holgerhass@vinzenz.de
Klein
Reinhild
R
Nehls
Oliver
O
Kaiser
Stephan
S
D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology / Q000276:immunology; D007370:Interferon Type I / Q000008:administration & dosage* / Q000009:adverse effects; D016898:Interferon-alpha; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D013959:Thyroid Diseases / Q000139:chemically induced / Q000209:etiology* / Q000276:immunology / Q000821:virology; D013961:Thyroid Gland / Q000276:immunology* / Q000378:metabolism / Q000821:virology; D013966:Thyroiditis / Q000209:etiology / Q000276:immunology; D013972:Thyrotropin / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D001323:Autoantibodies; D007370:Interferon Type I; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; C050739:interferon alfacon-1; D013972:Thyrotropin