BACKGROUND: Thyroid dysfunction (TD) is associated to chronic hepatitis C (HCV) and interferon (IFN) therapy. The prevalence of TD at baseline and during IFN therapy among stages of hepatic fibrosis is unknown. GOALS: To examine the frequency of TD at baseline and during Peg-IFN therapy among patients with severe and mild fibrosis. STUDY: 100 patients were treated with Peg-IFN and divided in 2 groups (50 each), according to liver histology; Metavir 0-2 (mild fibrosis) and Metavir 3-4 (severe fibrosis). Baseline TD was defined as history of TD, or abnormal thyroid stimulating hormone (TSH) or antiperoxidase thyroid auto-antibodies (TPO -Ab). Frequency of TD during therapy was defined as TD that required treatment. RESULTS: 20% in the severe fibrosis group and 10% in the mild fibrosis group, had TD at baseline. Most of the cases, 31.4% were female as compared to 6.25% males. During therapy, 24% of patients in the severe fibrosis group, compared to 12% in the mild fibrosis, had TD. Most patients had biochemical hypothyroidism, and 66% were female, compared to 33.33 % male. TPO-Ab predicted TD during therapy in 50% of cases while those negative only had 16.6% TD during IFN therapy. CONCLUSIONS: Patients with severe fibrosis have more TD events at baseline and during treatment with Peg IFN alfa-2a. Patients with more hepatic fibrosis require careful attention to diagnose and manage TD. More research in the immune mechanisms of hepatic fibrosis progression and autoimmune complications is needed.
BACKGROUND:Thyroid dysfunction (TD) is associated to chronic hepatitis C (HCV) and interferon (IFN) therapy. The prevalence of TD at baseline and during IFN therapy among stages of hepatic fibrosis is unknown. GOALS: To examine the frequency of TD at baseline and during Peg-IFN therapy among patients with severe and mild fibrosis. STUDY: 100 patients were treated with Peg-IFN and divided in 2 groups (50 each), according to liver histology; Metavir 0-2 (mild fibrosis) and Metavir 3-4 (severe fibrosis). Baseline TD was defined as history of TD, or abnormal thyroid stimulating hormone (TSH) or antiperoxidase thyroid auto-antibodies (TPO -Ab). Frequency of TD during therapy was defined as TD that required treatment. RESULTS: 20% in the severe fibrosis group and 10% in the mild fibrosis group, had TD at baseline. Most of the cases, 31.4% were female as compared to 6.25% males. During therapy, 24% of patients in the severe fibrosis group, compared to 12% in the mild fibrosis, had TD. Most patients had biochemical hypothyroidism, and 66% were female, compared to 33.33 % male. TPO-Ab predicted TD during therapy in 50% of cases while those negative only had 16.6% TD during IFN therapy. CONCLUSIONS:Patients with severe fibrosis have more TD events at baseline and during treatment with PegIFN alfa-2a. Patients with more hepatic fibrosis require careful attention to diagnose and manage TD. More research in the immune mechanisms of hepatic fibrosis progression and autoimmune complications is needed.
Authors: Mark S Sulkowski; Curtis Cooper; Bela Hunyady; Jidong Jia; Pavel Ogurtsov; Markus Peck-Radosavljevic; Mitchell L Shiffman; Cihan Yurdaydin; Olav Dalgard Journal: Nat Rev Gastroenterol Hepatol Date: 2011-03-08 Impact factor: 46.802
Authors: Manal M Hassan; Ahmed Kaseb; Donghui Li; Yehuda Z Patt; Jean-Nicolas Vauthey; Melanie B Thomas; Steven A Curley; Margaret R Spitz; Steven I Sherman; Eddie K Abdalla; Marta Davila; Richard D Lozano; Deena M Hassan; Wenyaw Chan; Thomas D Brown; James L Abbruzzese Journal: Hepatology Date: 2009-05 Impact factor: 17.425
Authors: Luis A Salazar; Xóchitl Garcia-Samper; Rafael Suarez-Carpio; María C Jimenez-Martínez; Erika P Rendón-Huerta; Felipe A Masso; Teresa I Fortoul; Luis F Montaño Journal: Hepat Res Treat Date: 2010-03-08