High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy

Abstract

After describing two cases of Hashimoto's thyroiditis associated with chronic hepatitis C, we set up a prospective study to assess the prevalence of thyroid autoantibodies (thyroglobulin and thyroid microsomal autoantibodies) in 72 chronic hepatitis C patients (43 men and 29 women; mean age = 51 +/- 2.1 yr) before interferon therapy admitted between January and December 1991 to our liver unit. Thyroid autoantibodies were systematically assayed in 60 chronic HBsAg-positive patients (34 men and 26 women; mean age = 50 +/- 2.2 yr), who served as controls. Antibody to hepatitis C virus was detected with a second-generation enzyme immunoassay and then confirmed with a recombinant immunoblot assay and a supplemental enzyme immunoassay using two beads. In chronic hepatitis C patients, no men had thyroid autoantibodies. Nine of 29 women (31%) had thyroid autoantibodies. Among them, six (20.7%) had high titers of thyroid autoantibodies, and two had hypothyroidism. In all nine of these women, hepatitis C virus viremia was detected on nested polymerase chain reaction (with primers located in the 5' untranslated region). One year later, titers of thyroid autoantibodies had increased in one patient. Three other patients progressed to hypothyroidism. We judged four of 29 patients (13.8%) to have Hashimoto's thyroiditis on the basis of their high titers of thyroid autoantibodies and biological features of hypothyroidism. In the control group, only one man had thyroid microsome autoantibodies, at a very low titer (1:100). The association between chronic hepatitis C and presence of thyroid autoantibodies is clearly confirmed (p = 0.021) by this study.

Association of Parvovirus B19 Infection and Hashimoto's Thyroiditis in Children

“…The initial presence of parvovirus B19-specific IgM antibodies and IgG antibodies directed against epitopes present in denatured VP2 proteins (VP-C) indicate recent infection. (6), p ϭ 0.01 28.9 (25) toantibodies is reduced compared to chronic HCV infection. However, as parvovirus B19 is a ubiquitous infection during childhood and adolescence, and hepatitis C infection is rare in children, the economic costs of B19-induced morbidity may justify further research and the development of a vaccine.…”

“…Since the seroprevalence of B19-specific antibodies is definitely higher, it becomes obvious that only a small proportion of parvovirus B19 infections may induce Hashimoto's thyroiditis. In patients with chronic hepatitis C, the relative proportion of autoimmune thyropathy varies between 7.5 and 12.5% (1,15,16,25). One may conclude that the potential of parvovirus B19 to induce the production of anti-thyroid au- The first analysis was performed 5 mo after manifestation of the disease.…”

“…There is substantial evidence that viral and bacterial infections may play a role in the induction of thyroid autoimmunity. Autoimmune thyroiditis has been linked to infections with EBV, HTLV-1, hepatitis C, and Yersinia enterocolitica (4,10,(15)(16)(17)21,25,27). It may also be induced by recombinant alpha interferon therapy during treatment of hepatitis C (1,5,9).…”

Celiac Disease and Non-organ-specific Autoantibodies in Patients with Chronic Hepatitis C Virus Infection

“…In fact, HCV-positive patients have a raised prevalence of autoimmune disorders such as mixed cryoglobulinemia, membranoproliferative glomerulonephritis, autoimmune thyroiditis, etc. [26][27][28][29][30]. In this context, several studies have previously reported high prevalence of NOSA in HCV-patients, but at low titer and apparently not associated with any type of immunological disease [20,31].…”

Dysthyroïdie lors d’une hépatite C

“…Dans cette étude, Tran et al [6] avaient évalué la prévalence des anticorps antithyroïdiens dans un groupe de patients suivis pour une hépatite C (43 hommes et 29 femmes) et dans un groupe contrôle de patients suivis pour une hépatite B. Les résultats étaient en faveur d'une prévalence plus élevée de l'augmentation des anticorps antithyroïdiens chez les femmes (31 % des cas) dont 13,8 % ont présenté une thyroïdite de Hashimoto. Des résultats similaires ont été rapportés par Deutsch et al [7].…”