Incidence of and risk factors for thyroid dysfunction during peginterferon alpha and ribavirin treatment in patients with chronic hepatitis C.
10.3904/kjim.2015.30.6.792
- Author:
Yong HWANG
1
;
Won KIM
;
So Young KWON
;
Hyung Min YU
;
Jeong Han KIM
;
Won Hyeok CHOE
Author Information
1. Department of Medicine, Konkuk University School of Medicine, Seoul, Korea. sykwonmd@hotmail.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Hepatitis C, chronic;
Thyroid diseases;
Interferons;
Incidence;
Risk factors
- MeSH:
Adult;
Aged;
Antiviral Agents/*adverse effects;
Autoantibodies/blood;
Biomarkers/blood;
Drug Therapy, Combination;
Female;
Hepatitis C, Chronic/diagnosis/*drug therapy;
Humans;
Incidence;
Interferon-alpha/*adverse effects;
Male;
Middle Aged;
Polyethylene Glycols/*adverse effects;
Recombinant Proteins/adverse effects;
Republic of Korea;
Retrospective Studies;
Ribavirin/*adverse effects;
Thyroid Diseases/*chemically induced/diagnosis/epidemiology/immunology/physiopathology;
Thyroid Gland/*drug effects/immunology/physiopathology;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2015;30(6):792-800
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Thyroid dysfunction (TD) is more likely to occur in patients with chronic hepatitis C (CHC) and is particularly associated with interferon (IFN) treatment. The purpose of this study was to investigate the incidence, outcomes, and risk factors for TD during pegylated interferon (PEG-IFN) and ribavirin (RBV) combined therapy in patients with CHC. METHODS: A total of 242 euthyroid patients with CHC treated with PEG-IFN/RBV were included. Thyroid function and autoantibodies were measured at baseline, and virologic response and thyroid function were assessed every 3 months during therapy. RESULTS: TD developed in 67 patients (27.7%) during the PEG-IFN/RBV treatment. The types of TD were subclinical hypothyroidism (50.7%), hypothyroidism (14.9%), thyroiditis (11.9%), subclinical hyperthyroidism (10.4%), and hyperthyroidism (10.4%). Most of the patients with TD recovered spontaneously; however, seven patients (10.4%) needed thyroid treatment. The sustained virological response rate was higher in patients with TD than those without (65.7% vs. 49.1%, p = 0.02). Baseline thyroid stimulating hormone (TSH) concentrations (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.96 to 8.77; p < 0.001), presence of the thyroid peroxidase antibody (OR, 8.81; 95% CI, 1.74 to 44.6; p = 0.009), and PEG-IFNalpha-2b (OR, 3.01; 95% CI, 1.43 to 6.39; p = 0.004) were independent risk factors for the development of TD. CONCLUSIONS: TD developed in 27.7% of patients with CHC during PEG-IFN/RBV treatment, and 10.4% of these patients needed thyroid treatment. TD is associated with a favorable virologic response to PEG-IFN/RBV. Assessment of TSH and thyroid autoantibodies at baseline and close monitoring of thyroid function during PEG-IFN/RBV therapy are necessary for early detection and management of IFN-induced TD.
