Incidence of Thyroid Dysfunction During Interferon Alfa-2b and Ribavirin Therapy in Men With Chronic Hepatitis C

[Guest guest]

Incidence of Thyroid Dysfunction During Interferon Alfa-2b and Ribavirin

Therapy in Men With Chronic Hepatitis C

A Prospective Cohort Study

Edmund J. Bini, MD, MPH; Saurabh Mehandru, MD

Arch Intern Med. 2004;164:2371-2376.

Background Thyroid dysfunction is a known complication of interferon

monotherapy in women with hepatitis C virus (HCV) infection. The aims of

this study were to determine the incidence and long-term outcome of thyroid

dysfunction in HCV-infected men receiving interferon and ribavirin

combination therapy.

Methods We prospectively studied 225 HCV-infected men with baseline levels

of thyrotropin (TSH) within the reference range who were treated with

subcutaneous interferon alfa-2b (3 million units 3 times per week) and oral

ribavirin (1000-1200 mg/d) for 24 to 48 weeks. Patients underwent screening

of TSH levels every 12 weeks during HCV therapy and at weeks 12 and 24 after

completion of treatment. Patients with abnormal TSH levels underwent a

comprehensive thyroid evaluation.

Results Among the 225 patients, overt thyroid disease developed in 6.7%

(95% confidence interval, 3.8%-10.8%), and subclinical thyroid disease was

diagnosed in 4.0% (95% confidence interval, 1.8%-7.4%). In the 12 patients

with overt hypothyroidism, antithyroglobulin antibodies were present in 11

and antithyroid peroxidase antibodies were present in 10, whereas

thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals

with overt hyperthyroidism. Most of the patients with thyroid dysfunction

completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients

with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9

with subclinical thyroid disease.

Conclusions Men with HCV infection treated with interferon and ribavirin

should undergo routine screening for thyroid disease. Treatment of HCV can

be safely continued in these patients because thyroid disease responds well

to treatment and is reversible in most individuals.

Author Affiliations: Department of Medicine and Division of

Gastroenterology, Veterans Affairs New York Harbor Healthcare System and New

York University School of Medicine, New York.

Archives of Internal Medicine

Arch Intern Med. 2004;164:2303.

[Guest guest]

Incidence of Thyroid Dysfunction During Interferon Alfa-2b and Ribavirin

Therapy in Men With Chronic Hepatitis C

A Prospective Cohort Study

Edmund J. Bini, MD, MPH; Saurabh Mehandru, MD

Arch Intern Med. 2004;164:2371-2376.

Background Thyroid dysfunction is a known complication of interferon

monotherapy in women with hepatitis C virus (HCV) infection. The aims of

this study were to determine the incidence and long-term outcome of thyroid

dysfunction in HCV-infected men receiving interferon and ribavirin

combination therapy.

Methods We prospectively studied 225 HCV-infected men with baseline levels

of thyrotropin (TSH) within the reference range who were treated with

subcutaneous interferon alfa-2b (3 million units 3 times per week) and oral

ribavirin (1000-1200 mg/d) for 24 to 48 weeks. Patients underwent screening

of TSH levels every 12 weeks during HCV therapy and at weeks 12 and 24 after

completion of treatment. Patients with abnormal TSH levels underwent a

comprehensive thyroid evaluation.

Results Among the 225 patients, overt thyroid disease developed in 6.7%

(95% confidence interval, 3.8%-10.8%), and subclinical thyroid disease was

diagnosed in 4.0% (95% confidence interval, 1.8%-7.4%). In the 12 patients

with overt hypothyroidism, antithyroglobulin antibodies were present in 11

and antithyroid peroxidase antibodies were present in 10, whereas

thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals

with overt hyperthyroidism. Most of the patients with thyroid dysfunction

completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients

with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9

with subclinical thyroid disease.

Conclusions Men with HCV infection treated with interferon and ribavirin

should undergo routine screening for thyroid disease. Treatment of HCV can

be safely continued in these patients because thyroid disease responds well

to treatment and is reversible in most individuals.

Author Affiliations: Department of Medicine and Division of

Gastroenterology, Veterans Affairs New York Harbor Healthcare System and New

York University School of Medicine, New York.

Archives of Internal Medicine

Arch Intern Med. 2004;164:2303.

[Guest guest]

Incidence of Thyroid Dysfunction During Interferon Alfa-2b and Ribavirin

Therapy in Men With Chronic Hepatitis C

A Prospective Cohort Study

Edmund J. Bini, MD, MPH; Saurabh Mehandru, MD

Arch Intern Med. 2004;164:2371-2376.

Background Thyroid dysfunction is a known complication of interferon

monotherapy in women with hepatitis C virus (HCV) infection. The aims of

this study were to determine the incidence and long-term outcome of thyroid

dysfunction in HCV-infected men receiving interferon and ribavirin

combination therapy.

Methods We prospectively studied 225 HCV-infected men with baseline levels

of thyrotropin (TSH) within the reference range who were treated with

subcutaneous interferon alfa-2b (3 million units 3 times per week) and oral

ribavirin (1000-1200 mg/d) for 24 to 48 weeks. Patients underwent screening

of TSH levels every 12 weeks during HCV therapy and at weeks 12 and 24 after

completion of treatment. Patients with abnormal TSH levels underwent a

comprehensive thyroid evaluation.

Results Among the 225 patients, overt thyroid disease developed in 6.7%

(95% confidence interval, 3.8%-10.8%), and subclinical thyroid disease was

diagnosed in 4.0% (95% confidence interval, 1.8%-7.4%). In the 12 patients

with overt hypothyroidism, antithyroglobulin antibodies were present in 11

and antithyroid peroxidase antibodies were present in 10, whereas

thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals

with overt hyperthyroidism. Most of the patients with thyroid dysfunction

completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients

with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9

with subclinical thyroid disease.

Conclusions Men with HCV infection treated with interferon and ribavirin

should undergo routine screening for thyroid disease. Treatment of HCV can

be safely continued in these patients because thyroid disease responds well

to treatment and is reversible in most individuals.

Author Affiliations: Department of Medicine and Division of

Gastroenterology, Veterans Affairs New York Harbor Healthcare System and New

York University School of Medicine, New York.

Archives of Internal Medicine

Arch Intern Med. 2004;164:2303.

[Guest guest]

Incidence of Thyroid Dysfunction During Interferon Alfa-2b and Ribavirin

Therapy in Men With Chronic Hepatitis C

A Prospective Cohort Study

Edmund J. Bini, MD, MPH; Saurabh Mehandru, MD

Arch Intern Med. 2004;164:2371-2376.

Background Thyroid dysfunction is a known complication of interferon

monotherapy in women with hepatitis C virus (HCV) infection. The aims of

this study were to determine the incidence and long-term outcome of thyroid

dysfunction in HCV-infected men receiving interferon and ribavirin

combination therapy.

Methods We prospectively studied 225 HCV-infected men with baseline levels

of thyrotropin (TSH) within the reference range who were treated with

subcutaneous interferon alfa-2b (3 million units 3 times per week) and oral

ribavirin (1000-1200 mg/d) for 24 to 48 weeks. Patients underwent screening

of TSH levels every 12 weeks during HCV therapy and at weeks 12 and 24 after

completion of treatment. Patients with abnormal TSH levels underwent a

comprehensive thyroid evaluation.

Results Among the 225 patients, overt thyroid disease developed in 6.7%

(95% confidence interval, 3.8%-10.8%), and subclinical thyroid disease was

diagnosed in 4.0% (95% confidence interval, 1.8%-7.4%). In the 12 patients

with overt hypothyroidism, antithyroglobulin antibodies were present in 11

and antithyroid peroxidase antibodies were present in 10, whereas

thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals

with overt hyperthyroidism. Most of the patients with thyroid dysfunction

completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients

with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9

with subclinical thyroid disease.

Conclusions Men with HCV infection treated with interferon and ribavirin

should undergo routine screening for thyroid disease. Treatment of HCV can

be safely continued in these patients because thyroid disease responds well

to treatment and is reversible in most individuals.

Author Affiliations: Department of Medicine and Division of

Gastroenterology, Veterans Affairs New York Harbor Healthcare System and New

York University School of Medicine, New York.

Archives of Internal Medicine

Arch Intern Med. 2004;164:2303.