title: Delta hepatitis-related thyroid disease: a unique phenomenon.
abstract: BACKGROUND
  Hepatitis delta virus (HDV) infection is a serious health problem worldwide. Thyroid disturbances represent a major limitation to the efficacy of interferon treatment targeting chronic HDV (C-HDV) infection. Moreover, pre-treatment thyroid diseases may be influenced by interferon therapy. Despite this, the characteristic features of the thyroid diseases in C-HDV patients remain poorly characterised.
  
  
  OBJECTIVE
  To determine the prevalence of thyroid diseases and evaluate the impact of delta hepatitis on thyroid function tests.
  
  
  METHODS
  We retrospectively reviewed the charts of 127 hepatitis C virus (HCV)-negative adults, treatment-naive outpatients with C-HDV, between July 2013 and July 2014. Thyroid-stimulating hormone (TSH) and thyroid antibodies (TAbs) including anti-thyroid peroxidase antibodies (anti-TPO), liver transaminases, and other routine laboratory tests were conducted during the study period.
  
  
  RESULTS
  A total of 127 C-HDV patients (female 52.9%, mean age 54.5 ±8.01 years) were enrolled. The rate of hypothyroidism, defined as a TSH level above 10 IU/l, was 4.7%. No patient had hyperthyroidism. Both elevated levels of liver transaminases and HDV ribonucleic acid (HDV-RNA) were positively correlated with high levels of thyroid autoantibodies.
  
  
  CONCLUSIONS
  The rate of hypothyroidism is higher than the rate of hyperthyroidism at baseline. Most remarkably, for the first time we discovered a correlation between disturbed thyroid autoantibodies and elevated liver transaminases as well as high HDV-RNA levels even in euthyroid delta hepatitis patients. But in order to have an adequate understanding of such correlations, further studies are needed.
authors.affiliation: Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Suvak
authors.affiliation: Department of Gastroenterology, School of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ahmet Cumhur
authors.initials: AC
authors.lastname: Dulger
authors.affiliation: Department of Emergency Medicine, School of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Mehmet Coskun
authors.initials: MC
authors.lastname: Aykaç
authors.affiliation: Department of Emergency Medicine, School of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Hayriye
authors.initials: H
authors.lastname: Gonullu
authors.affiliation: Department of Anaesthesiology, Van Region Training and Research Hospital, Van, Turkey.
authors.forename: Edip
authors.initials: E
authors.lastname: Gonullu
keywords: chronic hepatitis delta virus; hyperthyroidism; hypothyroidism