Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Abstract

Background & Aims: The involvement of thyroid autoimmunity and dysfunction in patients with chronichepatitis C virus (HCV) infection before interferon-α (IFN-α) therapy remains controversial. We performedthis meta-analysis to evaluate the association of HCV infection with the presence of anti-thyroid antibodiesand dysthyroidism.
 Methods: A literature search was carried out to collect articles dated up to August 2015 to identify observationalstudies which compared the prevalence of anti-thyroid antibodies and thyroid dysfunction in IFN-α naïvechronic HCV-infected subjects with non-HCV infected controls. Random-effect or fixed-effect meta-analyseswere applied and results reported as odds ratios (ORs) with 95% confidence intervals (CIs).
 Results: Twelve studies were included, involving 1,735 HCV-infected and 1,868 non-HCV infected subjects.Pooled anti-thyroid antibody prevalence tended to be higher in HCV-infected subjects. The prevalence ofanti-thyroglobulin antibody (TGAb), anti-thyroid peroxidase antibody (TPOAb), anti-thyroid microsomalantibody (ATMA) were 2.40-fold, 1.96-fold and 1.86-fold higher in HCV-infected subjects than in controls,respectively. The prevalence of hypothyroidism also differed by HCV infection status, with a pooled risk of3.10 (95%CI: 2.19-4.40) in HCV-infected subjects. However, the results did not show a significant differencein the prevalence of hyperthyroidism between the two groups.Conclusion: Chronic HCV infection may be an independent risk factor for thyroid disturbance. It is advisablefor the clinicians to monitor both thyroid antibodies and function in the course of chronic HCV infection,independent of IFN-α treatment.
 Abbreviations: AITD: autoimmune thyroid disease; ATMA: anti-thyroid microsomal antibody; CHC:chronic hepatitis; GD: Graves’ disease; HCV: hepatitis C virus; HT: Hashimoto’s thyroiditis; IFN-α: interferonalpha;NOS: Newcastle-Ottawa quality assessment scale; T3: triiodothyronine; T4: thyroxine; TGAb: antithyroglobulinantibody; TPOAb: anti-thyroid peroxidase antibody.

Thyroid Dysfunction in Non-Interferon Treated Hepatitis C Patients Residing in Hepatitis Endemic Area

“…This result is in accordance with other studies in which higher incidence of hypothyroidism as compared to hyperthyroidism is reported in HCV patients [15, 17]. According to a recent meta-analysis HCV patients are three times more prone to hypothyroidism as compared to control subjects [21]. Keeping in view a high incidence of TPO-Ab in local HCV patients it is expected that this hypothyroidism is probably autoimmune in origin [22].…”

Prospective role of thyroid disorders in monitoring COVID-19 pandemic

“…Previously, it was reported that patients who recovered from SARS showed low serum T3 and T4 levels which were due to damage caused by the SARS coronavirus to follicular cells of the thyroid gland [ 137 ]. Viral disease caused by hepatitis C virus (HCV) is also associated with rise in incidence and prevalence of thyroiditis [ 138 ]. A recent report suggests the prevalence of thyroid dysfunction in HIV infected adults [ 139 ].…”

Long-term outcomes and risk factors of thyroid dysfunction during pegylated interferon and ribavirin treatment in patients with chronic hepatitis C infection in Taiwan

“…Immunological reactions as well as virus invasion and replication in the affected extrahepatic tissues and organs are the main extrahepatic manifestations of HCV infection [6]. Previous studies have demonstrated that there is a high risk for thyroid autoimmunity and thyroid dysfunction (TD) in patients with HCV infection [7, 8].…”