Virus C genotype predisposes to primary hypothyroidism during interferon-α treatment for chronic hepatitis C

Abstract

Objective: The treatment of the chronic hepatitis C (HCV) with α-interferon is associated with thyroid dysfunction (TD). The aim of this study was to evaluate thyroid function outcome among patients with chronic HCV under treatment with conventional interferon (IFN) or peguilated interferon (PEG-IFN) in association with ribavirin. Patients and Methods: We studied 293 patients with chronic HCV, submitted to drug therapy for 24 or 48 weeks. Initially, we evaluated FT4, TSH, TPOAb, TgAb, and continued to monitor FT4 and TSH every three months during therapy and six months thereafter. Results: At baseline, TD prevalence was 6.82% (n = 20); 6.14% hypothyroidism; 0.68% hyperthyroidism. TPOAb was present in 5.46% of euthyroid patients. Out of 273 euthyroid patients at baseline, 19% developed TD: 17.2% hypothyroidism; 1.8% hyperthyroidism; 5.1% destructive thyroiditis (DT). 90% of TPOAb-positive patients at baseline developed hypothyroidism vs 14.5% of TPOAb-negative patients (p < 0.001). On average, TD occurred after 25.8 ± 15.5 weeks of treatment. 87.2% of patients who developed hypothyroidism did so during the first therapeutic cycle (p = 0.004; OR = 3.52; 95% CI = 1.36-9.65). Patients infected with genotype 1 virus were 2.13 times more likely to develop hypothyroidism (p = 0.036; 95% CI = 1.04-4.38). Hypothyroid and DT patients presented higher TSH levels before-treatment than patients who had remained euthyroid (p < 0.001; p = 0.002, respectively). DT patients presented lower qALT (p = 0.012) than euthyroid patients. Conclusion: Hypothyroidism was the most frequent TD, especially during the first cycle of α-interferon. Genotype 1 virus was associated with a risk two times higher for developing the illness. There was no need to interrupt or to change HCV treatment. Therefore, approximately 34% of TD was transient.

The presence of thyroid peroxidase antibody of IgG2 subclass is a risk factor for thyroid dysfunction in chronic hepatitis C patients

“…The patients enrolled in our study (TD and WTD groups) had similar distributions by sex, age, and virological indicators (HCV genotype and viral load). It has been reported that lower ALT and increased TPOAb levels were more commonly found in CHC patients with TD than those without thyroid disorders (19,20). We observed similar trends between TD and euthyroid patients.…”

Thyroid Dysfunction Related to Interferon in Turkish Patients with Viral Hepatitis: Incidence and Influencing Factors

“…Pavan MH. et al (23) have reported that TD development was more frequent in CHC genotype 1. As most of our study group had genotype 1b, a statistical analysis could not be done between genotype and TD development.…”

Dilated cardiomyopathy and hypothyroidism associated with pegylated interferon and ribavirin treatment for chronic hepatitis C: case report and literature review

“… 3 , 5 Studies have shown that the incidence of TD associated with IFN-α therapy differs markedly between racial and ethnic groups and fibrosis stages, with an incidence ranging from 10% to 27.7%. 2 , 3 , 4 , 5 , 6 The majority of TD is hypothyroidism, and more than half of them return spontaneously to normal after cessation of antiviral therapy. 3 , 4 , 5 , 6 However, a few patients, as well as our case, need permanent thyroid hormone replacement therapy.…”

“… 2 , 3 , 4 , 5 , 6 The majority of TD is hypothyroidism, and more than half of them return spontaneously to normal after cessation of antiviral therapy. 3 , 4 , 5 , 6 However, a few patients, as well as our case, need permanent thyroid hormone replacement therapy. 3 , 4 , 5 , 6 Fortunately, it does not always necessitate alteration or discontinuation of therapy due to TD, 2 , 3 , 4 , 5 , 6 , 17 and it also does not impact the response to combination therapy with interferon and ribavirin.…”

“…Interferon-α (IFN-α)-induced thyroid dysfunction (TD) has been well documented, with an incidence ranging from 10% to 27.7%. 2 , 3 , 4 , 5 , 6 Cardiovascular complications caused by interferon consists mainly of arrhythmia, myocarditis, reversible hypertension, ischemic heart disease, pericarditis and pericardial effusion. 7 , 8 , 9 , 10 However, few cases of interferon-induced cardiomyopathy have been reported.…”