RESUMO
Autoimmune thyroid dysfunction, a cluster of conditions in which the immune system can either attack or stimulate thyroid tissue, has been associated with HCV infection. Autoimmune thyroid disease can take various forms, from the symptoms of hypothyroidism to the palpable goiters. Therefore, this work aimed to estimate the prevalence of thyroid dysfunction in HCV genotype 4 Egyptian patients and assess the effect of interferon therapy on it. Also to study the association between thyroid disorders, TNF-alpha and liver function parameters among HCV infected patients. A case control study was conducted on 253 HCV genotype 4 patients selected randomly, attended to National liver Institute, Monuflya University, The patients were divided into two groups. 220 chronic HCV patients not treated with any anti-viral therapy. 33 chronic HCV patients, treated with pegylated interferon [Peg-IFN] combined with ribavirin for 12 months. For both groups of patients, PCR test were done. Also liver biopsy was performed before treatment to assess hepatic fibrosis using histological hepatic activity index [HAI] of Knodell et al and modification of Ishak et al. In addition to 19 healthy individuals without any thyroid dysfunction or liver diseases used as control group. Levels of thyroid-stimulating hormone [TSH], total thyroxine [T4], triiodothyronine [T3] and tumor necrosis factor alpha, also all liver function tests were measured. The overall prevalence of thyroid disorders among non treated group was 13.6 percent [30 cases], 63.3 percent of them were females, 13 [5.9 percent] were hyperthyroidism, 8 [61.5 percent] of them were females, and 17 [7.7 percent] were hypothyroidism, 11 [64.7 percent] of them were females. While the prevalence among HCV treated patients were 15.1 percent [5 cases], all of them had hypothyroid function only, 4 [80 percent] of them were females .The serum tumor necrosis factor alpha [TNF- alpha] levels significantly increased in HCV infected non treated patients when compared with control group [p< 0.001], and in treated patients when compared with non-treated group [p < 0.001]. TNF-alpha level showed significant positive correlation with thyroid stimulating hormone [TSH] in HCV treated group and significant negative correlation with albumin and aspartate transaminase [AST] in the HCV non-treated group. HCV infection are associated with thyroid dysfunction especially after interferon and ribavirin treatment TNF-alpha may play a role in inducing autoimmune thyroid disorders. This implies that these patients should be screened for thyroid function on a periodic basis especially interferon treated cases