Virologic factors related to interferon-alpha-induced thyroid dysfunction in

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Eur J Endocrinol 2000 May;142(5):431-7

Virologic factors related to interferon-alpha-induced

thyroid

dysfunction in

patients with chronic hepatitis C.

Hsieh MC, Yu ML, Chuang WL, Shin SJ, Dai CY, Chen SC,

Lin ZY, Hsieh MY,

Liu

JF, Wang LY, Chang WY

Department of Internal Medicine, Koahsiung Medical

University,

Koahsiung,

Taiwan, Republic of China.

OBJECTIVE: Hepatitis C virus (HCV), being reported to

be associated

with a

high prevalence of serological markers of autoimmunity

in HCV-infected

patients, and possibly sharing partial sequences in

amino acid segments

with

thyroid tissue antigens, may be associated with

interferon-alpha

(IFN-alpha)-induced thyroid dysfunction in chronic

hepatitis C

patients. We

conducted this study to clarify the issue. DESIGN AND

METHODS: One

hundred

and fifty chronic hepatitis C patients with normal

baseline thyroid

function

were treated with IFN-alpha 2a, 2b and n1 (3-6 million

Units three

times

weekly for 24 weeks). Pretreatment sera were tested

for HCV genotype

and HCV

RNA levels. Serum thyrotropin, total thyroxine and

free thyroxine index

were

performed every 4 weeks for 24 weeks followed by every

8 weeks for

another

24 weeks. RESULTS: Twenty-one (14.0%) patients

developed early thyroid

dysfunction (abnormal thyroid function during the

first 3 months of

therapy). Female gender, lower HCV RNA levels,

IFN-alpha n1 and a lower

IFN-alpha dose were significantly associated with

early thyroid

dysfunction.

On multivariate analysis, gender, IFN-alpha

preparation and HCV RNA

levels

were the significant factors associated with early

thyroid dysfunction.

Seven (4.7%) patients developed thyroid dysfunction

during the second 3

months of IFN-alpha therapy. Taken together, 18.7%

patients developed

thyroid dysfunction. Female, mixed HCV genotype

infection and lower HCV

RNA

levels were significantly associated with thyroid

dysfunction. However,

only

gender remained significantly associated with

IFN-alpha-induced thyroid

dysfunction in multivariate analysis. CONCLUSIONS: The

virologic

features of

HCV may be associated with thyroid dysfunction in

chronic hepatitis C

patients treated with IFN-alpha. Nevertheless, gender

still plays the

most

important role in IFN-alpha-induced thyroid

dysfunction.

PMID: 10802518, UI: 20263618

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