Background Thyroiditis is an important extrahepatic association in chronic hepatitis C virus (HCV) infection. There have been reports of an association between SARS-CoV-2 infection and the onset or re-activation of autoimmune hypothyroidism. Therefore, we performed this prospective observational study of 42 patients with COVID-19 infection and a history of hepatitis C virus infection and thyroid disease with follow-up thyroid function and autoantibody testing. Material/Methods From April 2020 to October 2020, we performed a prospective observational study of patients with cured hepatitis C virus (HCV) infection and documented thyroid disease who became infected with SARS-CoV-2 (confirmed by SARS-CoV-2 RNA detection via reverse-transcription polymerase chain reaction [RT-PCT] from the upper respiratory tract, both nasal and pharyngeal swabs). Evaluation at 1 and 3 months after SARS-CoV-2 infection included serum determination of antithyroid antibodies (anti-thyroglobulin [anti-Tg] and antithyroid peroxidase [ATPO]), thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and evaluation of thyroid medication, with dose adjustment if required. Results One-month follow-up showed that both patients with autoimmune thyroiditis as well as patients without antibodies had increased ATPO levels. Also, levels of TSH, fT3, and fT4 were significantly decreased. At 3-month follow-up, levels of ATPO were decreased in all patient groups and the levels of thyroid hormones increased to normal values. Conclusions This study supports previous reports of an association between SARS-CoV-2 infection and thyroid dysfunction associated with thyroid autoantibodies. Thyroid function tests may be considered as part of the laboratory work-up in patients with COVID-19.

Background In the European Union, a tablet with fixed doses of ombitasvir, paritaprevir, and ritonavir combined with dasabuvir is an authorized treatment for patients with chronic hepatitis C virus (HCV) infection. Ribavirin is a broad-spectrum antiviral used in several treatment regimens for patients with HCV infection. This real-world study aimed to compare the safety and efficacy of ombitasvir, paritaprevir, and ritonavir combined with dasabuvir, with or without ribavirin, in 587 patients with chronic hepatitis C attending the Fundeni Clinical Institute, Bucharest, Romania. Material/Methods This is an observational prospective study including 315 patients with F4 degree of fibrosis and compensated cirrhosis, 185 patients with F3 fibrosis, and 83 patients with F2 fibrosis. Liver fibrosis was evaluated by liver biopsy or Fibromax. Efficacy was defined as undetectable HCV-RNA at 12 weeks after the end of treatment. In terms of safety, we monitored the development of adverse reactions, liver cytolysis, cholestasis, and hematologic disorders. Results Of the 587 patients, 2 patients with B-cell lymphoma died during therapy. In total, 3/585 patients (0.51%) did not achieve sustained virologic response. Common adverse effects were nausea and asthenia (especially in patients with other medical treatments; P =0.03 and P =0.04, respectively) and anemia in patients who received ribavirin ( P <0.01). None of the patients discontinued antiviral treatment. Patients with kidney transplant or end-stage kidney disease did not receive or discontinued ribavirin. Conclusions Ombitasvir, paritaprevir, and ritonavir combined with dasabuvir, with or without ribavirin had an efficacy rate of over 99% in HCV genotype 1b infection. We report no serious adverse reactions.

Aim: The aim of this study is to assess the evolution of Fibromax® parameters (fibrosis, inflammation, steatosis, steatohepatitis) in patients with chronic HCV hepatitis at one year after sustained virologic response (SVR) achieved by direct acting antiviral agents (DAA). Methods: This is a retrospective observational trial including 73 patients with chronic HCV hepatitis, who obtained sustained virologic response under ombitasvir/paritaprevir/ritonavir and dasabuvir, ledipasvir/sofosbuvir or sofosbuvir/velpatasvir. All the patients were evaluated by Fibromax before the initiation of therapy and at 12 months after SVR. Results and Conclusion: The study included 42 women (57.53%) and 31 men (42.46%), without significant difference in mean age or BMI. We found a higher prevalence of patients with minimal or moderate fibrosis (F1, F2), compared to patients with advanced fibrosis (F3) (63.01% versus 10.95%). At one year follow-up, we found an increased number of patients in the lower levels of fibrosis, inflammation and NASH, with a relatively constant distribution of patients regarding steatosis. Necro-inflammatory activity was significantly diminished, with 58 patients in the no to minimal activity, compared to 37 patients before antiviral therapy. More patients presented N0 and N1 degree of NASH at follow-up than before therapy (63 patients versus 42 patients, p= 0.02). The mean values of Fibrotest (p= 0.03), ActiTest (p<0.01) and NashTest (p=0.02) decreased significantly. The mean value of Steatotest also decreased, but without statistical significance (p=0.12).