title: Development of thyroid diseases in the treatment of chronic hepatitis C with alpha-interferon may be a good prognosticator in achieving a sustained virological response: a meta-analysis.
abstract: OBJECTIVE
  Thyroid dysfunction is the most common endocrinopathy associated with hepatitis C and its interferon-based treatment. When undergoing treatment, interferon and ribavirin synergize to potently stimulate the immune system in order to eradicate the virus. One of the innocent bystanders in this accentuated response is the thyroid. The present study investigated whether thyroid dysfunction while undergoing combination treatment for hepatitis C is a favorable prognostic maker for a sustained virological response.
  
  
  METHODS
  We carried out a prospective clinical audit in 201 patients treated with combination ribavirin and alpha-interferon and determined the prevalence of sustained virological response in patients in association with thyroid disease. A meta-analysis was also carried out pooling 741 patients from four previous studies on this topic.
  
  
  RESULTS
  There was positive and significant association between thyroid disease and viral clearance. This was not supported by the meta-analysis, however, and some plausible explanations are proffered for this inconsistency.
  
  
  CONCLUSIONS
  Despite lacking supportive evidence from the meta-analysis, it is important that this information is confirmed (or refuted) in future studies.
authors.affiliation: Hunter Area Pathology Service, John Hunter Hospital, University of Newcastle, New South Wales, Australia. huy.tran@hnehealth.nsw.gov.au
authors.forename: Huy Anh
authors.initials: HA
authors.lastname: Tran
authors.forename: Glenn Edward
authors.initials: GE
authors.lastname: Malcolm Reeves
authors.forename: Robert
authors.initials: R
authors.lastname: Gibson
authors.forename: John Richard
authors.initials: JR
authors.lastname: Attia
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054869:Clinical Audit; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D018570:Risk Assessment; D013959:Thyroid Diseases / Q000139:chemically induced*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin