Thyroid function and anti‐thyroid autoantibodies in untreated children with vertically acquired chronic hepatitis C virus infection

Indolfi, Giuseppe; Stagi, Stefano; Bartolini, Elisa; Salti, R; Martino, Maurizio de; Azzari, Chiara; Resti, Massimo

doi:10.1111/j.1365-2265.2007.03009.x

Cited by 51 publications

(44 citation statements)

References 26 publications

(53 reference statements)

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“…1.3% had an abnormal thyroid function, who were than referred to an endocrinologist and 98.6% become euthyroid without any therapy this follow up was missing in previous studies [12]. Thus this study confirms previous findings that reversibility of thyroid dysfunction after completion of interferon and ribavirin therapy in hepatitis C virus patients [20,21]. Statistically significant (p-0.003) association was observed between the existence of diabetes and end treatment response of HCV because a positive association between chronic HCV infection and DM has been consistently demonstrated across different ethnicities and geographic regions, in both developed and developing countries [22].…”

Section: Discussionsupporting

confidence: 82%

Sub-Clinical Thyroid Disorders in Patients With Hepatitis C Before and After Conventional Treatment

Rahman¹,

Amir²,

Aziz³

et al. 2017

J Diabetes Metab

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Objective: Thyroid dysfunction represents one of the commonest endocrine manifestations of chronic hepatitis C infection, exaggerated by interferon based treatment. The purpose of this study was to assess the frequency of hepatitis C virus and sub-clinical thyroid disorder in patients with hepatitis C before and after treatment.Methods: This is an observational, cross sectional analysis conducted in Lyari general hospital and Abbasi Shaheed hospital from January 2009 to December 2015. Patients with a positive rt-PCR and genotype 3 were included in the study. After a positive rt-PCR, patients were screened by thyroid stimulating hormone before starting the treatment. All patients were given therapy of conventional interferons (3 million units thrice weekly) and ribavirin (800 mg per day in two divided doses) for a period of 6 months. Patient with normal TSH level was included and patients with a co-existing hepatitis B or D were excluded from the study. After 6 months of therapy all patients had a repeat rt-PCR to see the end treatment response to therapy and a thyroid stimulating hormone to screen for thyroid disorders.Results: A total of 129,430 patients have visited the medical outpatient department of which, 4069 were HCV RNA PCR positive. The prevalence of unrecognized hepatitis C Virus was 13.4% in the study population. The prevalence of sub-clinical thyroid disorders was 9%. Of which 6.5% had sub-clinical hypothyroidism and 2.5% had overt or subclinical hyperthyroidism. A total of 2196 patients were included in the analysis. Mean age was 36.22 ±10.01 years range from 16 to 63 years. Among all 36.9% were male and 5.1% were known diabetics. On the whole 14.8% were non-responders, 80.9% achieved an end treatment response and 4.3% lost to follow up. We observed an association between the post treatment TSH level and the ETR of HCV (p=0.015). A statistically significant difference (p<0.001; 95% CI -3.008-1.577) was observed in the thyroid stimulating hormone at the baseline and following the conventional interferon and ribavirin therapy for a period of 6 months. 388 (17.6%) patients had abnormal thyroid function tests after conventional interferon treatment. These 388 patients were further followed up for 6 months. Conclusion:In conclusion, this study results shows 13.4% prevalence of HCV in Karachi and the prevalence of sub-clinical thyroid disorders was 9%, of which 6.5% and 2.5% had overt hypothyroidism and hyperthyroidism respectively.

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Section: Discussionsupporting

confidence: 82%

Sub-Clinical Thyroid Disorders in Patients With Hepatitis C Before and After Conventional Treatment

Rahman¹,

Amir²,

Aziz³

et al. 2017

J Diabetes Metab

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“…However, recently, several studies have confirmed an association of hepatitis C virus (HCV) infection with AITD both in adults [39,40] and in children [41].…”

Section: Hcvmentioning

confidence: 98%

Autoimmune thyroid disorders

Antonelli

Ferrari

Corrado

et al. 2015

Autoimmunity Reviews

678

588

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“…HCV can infect human thyrocytes resulting in production of proinflammatory cytokines, which may enhance the autoimmune response (87). Indeed, thyroid antibodies are more frequent in children with untreated HCV infection than in controls (88). Enteroviruses have been detected in thyroid tissue of subjects with Hashimoto's thyroiditis (89).…”

Section: Stressmentioning

confidence: 99%

MECHANISMS IN ENDOCRINOLOGY: Autoimmune thyroid disease: old and new players

Effraimidis

Wiersinga

2014

European Journal of Endocrinology

284

196

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The last 10 years have seen some progress in understanding the etiology of autoimmune thyroid disease (AITD). The female preponderance can now be explained -at least in part -by fetal microchimerism and X-chromosome inactivation. The number of identified susceptibility genes for AITD is increasing (among others now including TSHR, TG, HLA, CTLA4, PTPN22, CD40, FCRL3, IL2RA, and FOXP3), but these genes together probably do not explain more than about 10% of the heritability of AITD. As twin studies indicate that genes contribute for 70% of AITD, it follows that there must be many more loci, each of them contributing a little. While the genetic studies have clarified why various autoimmune diseases so often cluster in the same patient, the molecular mechanism of action of these genetic polymorphisms (frequently located in introns) has hardly been explained. Polymorphisms in AITD susceptibility genes may become helpful in clinical practice, e.g. in assessing risk of recurrent Graves' hyperthyroidism (GH) after a course of antithyroid drugs. Moderate alcohol intake decreases the risk on overt GH and overt Hashimoto's hypothyroidism. Current smokers -as well known -are at increased risk for Graves' disease, but -surprisingly -at diminished risk for Hashimoto's thyroiditis. Low selenium and low vitamin D levels might increase the risk of developing AITD, but data are still inconclusive. Current options for preventive interventions in subjects at risk to develop AITD are very limited.

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Thyroid function and anti‐thyroid autoantibodies in untreated children with vertically acquired chronic hepatitis C virus infection

Abstract: Our data suggest a role for HCV infection in the development of nonautoimmune thyroid disease in untreated HCV-infected children, confirming previous studies in adults. Clinicians should be aware of thyroid dysfunction even in untreated children.

Cited by 51 publications

References 26 publications

Sub-Clinical Thyroid Disorders in Patients With Hepatitis C Before and After Conventional Treatment

Sub-Clinical Thyroid Disorders in Patients With Hepatitis C Before and After Conventional Treatment

Autoimmune thyroid disorders

MECHANISMS IN ENDOCRINOLOGY: Autoimmune thyroid disease: old and new players

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