Thyroid dysfunctions in patients with viral hepatitis treated with interferon-alpha

ArticleinOrvosi Hetilap 145(23):1211-6 · July 2004with2 Reads
Source: PubMed
Abstract

Many studies have explored that thyroid dysfunctions can be induced by cytokine therapy. Most observations were collected in connection with the treatment of viral hepatitis with interferon-alpha. Frequency and types of thyroid dysfunction developed during and after recombinant interferon-alpha treatment were studied in 138 patients with viral hepatitis C or B. Therapy lasted 12 months or more, subjects having thyroid dysfunction at the start of therapy were excluded from the study. Thyroid parameters (TSH, FT4, FT3 and anti-TPO) were controlled every third month. In patients in whom thyroid dysfunction occurred the measurements were repeated monthly and other tests were also performed (anti-Tg, IL-6, TSH receptor antibody, thyroid scan and 99mTc-pertechnetate uptake). Thyroid function disturbances were found in 30 (21.7%) patients, 12 of them (8.7%) showed persistent hypothyroidism. Hyperthyroidism was transitory in all cases. The clinical course of thyroid dysfunction might be monophasic (hyper- or hypothyroidism), biphasic (hyperthyroidism followed by hypofunction) or triphasic. Immune and non-immune forms can be clearly distinguished. Every fifth patient with chronic hepatitis showed thyroid dysfunction during interferon-alpha therapy, it is necessary therefore to control the hormonal status and the thyroid antibody titer. Treated patients have to be informed in advance that as a "side effect" persistent hypothyroidism may develop.

    • "for those over 48 years versus younger patients). Other studies [4, 8, 31] reveal no association of thyroid dysfunctions with either dosage and duration of therapy or occurrence of thyroid autoimmunity and severity of disease. In our study, no association was found in severity of disease predicted on liver biopsy and occurrence of thyroid dysfunction. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective. To determine the association of thyroid dysfunction with the severity of the disease and response to treatment in patients of chronic hepatitis C. Design. Cohort study. Patients. One hundred and sixty seven noncirrhotic chronic hepatitis C patients were grouped into treatment group (n = 107) and control group (n = 60). Measurements. Baseline S. ALT and S. AST by IFCC and S. TSH, S. free T4, and S.T3 level were measured by chemiluminescence method. The severity of the disease was measured by Knodell histopathological index (HPI) on liver biopsy. Study group patients underwent 24-weeks IFN and ribavirin therapy and thyroid functions were determined at weeks 0, 12, and 24. Response to therapy was determined by PCR-HCV test. Results. 20 treated patients (18.69%) developed thyroid dysfunction with relative risk (RR) of 11.25 and attributable risk (AR) of 91%. Females were at higher risk. Hypothyroidism was common than hyperthyroidism. There was no significant association between thyroid dysfunction and severity of the disease (P = 0.81) and response to therapy (P = 0.79). Conclusion. Interferon-alpha and ribavirin therapy induces thyroid dysfunction in chronic hepatitis C patients. There is no association between severity of disease and response to therapy with interferon-induced thyroid dysfunction.
    Full-text · Article · Sep 2012 · Hepatitis research and treatment
    0Comments 3Citations
    • "for those over 48 years versus younger patients). Other studies [4, 8, 31] reveal no association of thyroid dysfunctions with either dosage and duration of therapy or occurrence of thyroid autoimmunity and severity of disease. In our study, no association was found in severity of disease predicted on liver biopsy and occurrence of thyroid dysfunction. "
    Full-text · Article · Jan 2012
    0Comments 0Citations
  • [Show abstract] [Hide abstract] ABSTRACT: The objective of this study was to assess the frequency of thyroid dysfunction in response to combination of interferon and ribavirin therapy in chronic hepatitis C (CHC) patients and HCV outcome. Descriptive study. Place and Duration of Study: This study was conducted at Outpatient Department of Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad from September 2005 to September 2007. One hundred cases of CHC, proven by anti-HCV and HCV RNA-positive with baseline TSH, FT4 and FT3 within the normal reference range, who were treated with interferon alpha-2b (3 million unit subcutaneously three times per week) and oral ribavirin (1000-1200 mg per day) were included in this study. All patients were assessed for TSH, FT4, FT3 levels at 12 weeks and 24 weeks during therapy. Among the 100 patients, overt thyroid disease developed in 13 (13%) and sub-clinical thyroid disease in 5 (5%). Out of 13 patients of overt thyroid disorders, 11 (84.6%) had hypothyroidism and 02 (15.3%) hyperthyroidism. Four (80%) patients were of sub-clinical hypothyroidism and 01 (20%) patient was of sub-clinical hyperthyroidism. Overall, thyroid disorders developed in 18 (18%) both as overt and sub-clinical thyroid disorders. Ninety one (91%) patients became negative by HCV RNA. Treatment of HCV with IFN-alpha and ribavirin can be safely continued in patients with over and sub clinical hypothyroidism because thyroid disease responds well to treatment.
    No preview · Article · Jul 2008 · Journal of the College of Physicians and Surgeons--Pakistan: JCPSP
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