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Virus C genotype predisposes to primary hypothyroidism during interferon-α treatment for chronic hepatitis C
Pavan, Maria Helena Postal; Pavin, Elizabeth João; Gonçales Júnior, Fernando Lopes; Wittmann, Denise Engelbrecht Zantut.
  • Pavan, Maria Helena Postal; Universidade Estadual de Campinas. Medical School. Campinas. BR
  • Pavin, Elizabeth João; UNICAMP. FCM. Campinas. BR
  • Gonçales Júnior, Fernando Lopes; UNICAMP. FCM. Campinas. BR
  • Wittmann, Denise Engelbrecht Zantut; UNICAMP. FCM. Campinas. BR
Braz. j. infect. dis ; 15(5): 449-456, Sept.-Oct. 2011. tab
Article in English | LILACS | ID: lil-612703
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 percent (n = 20); 6.14 percent hypothyroidism; 0.68 percent hyperthyroidism. TPOAb was present in 5.46 percent of euthyroid patients. Out of 273 euthyroid patients at baseline, 19 percent developed TD 17.2 percent hypothyroidism; 1.8 percent hyperthyroidism; 5.1 percent destructive thyroiditis (DT). 90 percent of TPOAb-positive patients at baseline developed hypothyroidism vs 14.5 percent of TPOAb-negative patients (p < 0.001). On average, TD occurred after 25.8 ± 15.5 weeks of treatment. 87.2 percent of patients who developed hypothyroidism did so during the first therapeutic cycle (p = 0.004; OR = 3.52; 95 percent CI = 1.36-9.65). Patients infected with genotype 1 virus were 2.13 times more likely to develop hypothyroidism (p = 0.036; 95 percent 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 percent of TD was transient.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Antiviral Agents / Polyethylene Glycols / Ribavirin / Interferon-alpha / Hepacivirus / Hepatitis C, Chronic / Hypothyroidism Type of study: Observational study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: UNICAMP/BR / Universidade Estadual de Campinas/BR

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Full text: Available Index: LILACS (Americas) Main subject: Antiviral Agents / Polyethylene Glycols / Ribavirin / Interferon-alpha / Hepacivirus / Hepatitis C, Chronic / Hypothyroidism Type of study: Observational study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: UNICAMP/BR / Universidade Estadual de Campinas/BR