Brief Articles
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World J Gastroenterol. Jan 21, 2009; 15(3): 328-333
Published online Jan 21, 2009. doi: 10.3748/wjg.15.328
Evolution and predictive factors of thyroid disorder due to interferon alpha in the treatment of hepatitis C
Moana Gelu-Simeon, Aurore Burlaud, Jacques Young, Gilles Pelletier, Catherine Buffet
Moana Gelu-Simeon, Aurore Burlaud, Gilles Pelletier, Catherine Buffet, Department of Hepatology and Gastroenterology, Bicetre Hospital, 78 rue du General Leclerc, Le Kremlin-Bicetre 94275, France
Jacques Young, Department of Endocrinology, Bicetre Hospital, 78 rue du General Leclerc, Le Kremlin-Bicetre 94275, France
Author contributions: Gelu-Simeon M and Burlaud A contributed equally to this work; Buffet C, Pelletier G and Gelu-Simeon M designed the research; Burlaud A performed the research; Gelu-Simeon M and Young J analyzed the data; Gelu-Simeon M wrote the paper.
Correspondence to: Dr. Moana Gelu-Simeon, Department of Hepatology and Gastroenterology, Bicetre Hospital, 78 rue du General Leclerc, Le Kremlin-Bicetre 94275, France. moana.gelu@chu-guadeloupe.fr
Telephone: +33-1-45213724
Fax: +33-1-45212042
Received: March 1, 2008
Revised: April 25, 2008
Accepted: May 1, 2008
Published online: January 21, 2009
Abstract

AIM: To study predictive factors of thyroid dysfunction associated with interferon-alpha (IFNα) therapy in chronic hepatitis C (CHC) and to describe its long-term evolution in a large population without previous thyroid dysfunction.

METHODS: We performed a follow-up of thyroid function and detection of thyroid antibodies in 301 patients treated for CHC with IFNα from 1999 to 2004.

RESULTS: Thyroid disorder developed in 30/301 (10%) patients with a mean delay of 6 ± 3.75 mo: 13 patients had hyperthyroidism, 11 had hypothyroidism, and 6 had biphasic evolution. During a mean follow-up of 41.59 ± 15.39 mo, 9 patients with hyperthyroidism, 3 with hypothyroidism, and 4 with biphasic evolution normalized thyroid function in 7.88 ± 5.46 mo. Recovery rate of dysthyroidism was not modified by treatment discontinuation, but was better for patients with negative thyroid antibodies before antiviral treatment (P = 0.02). Women had significantly more dysthyroidism (P = 0.05). Positive thyroid peroxidase and thyroglobulin antibodies were more frequent before antiviral treatment in patients who developed dysthyroidism (P < 0.0003 and P = 0.0003, respectively). In a multivariate model, low fibrosis was found to be a predictive factor of dysthyroidism (P = 0.039).

CONCLUSION: In this monocentric population of CHC, dysthyroidism, especially hyperthyroidism, developed in 10% of patients. Low fibrosis was found to be a predictive factor of dysthyroidism. Thyroid disorder recovered in 16/30 patients (53%) and recovery was better in the non-autoimmune form.

Keywords: Chronic hepatitis C; Interferon alpha; Predictive factors; Thyroid disorder