Peer-review started: May 6, 2015
First decision: October 14, 2015
Revised: October 28, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: January 18, 2016
Processing time: 261 Days and 11.9 Hours
The hepatitis C virus (HCV) infection is an important public health problem and it is associated with hepatic and extrahepatic manifestations. Autoimmune thyroid diseases are common in HCV infected patients and the standard interferon-based treatment is associated with an increase of the immune-mediated thyroid damage. Recent evidence in the literature analyzed critical points of the mechanisms of thyroid damage, focusing on the balance between the two sides of the interaction: The environment (virus infection with potential cross-reaction) and the host (susceptibility genes with consistent immune response). The spectrum of antiviral treatment for chronic HCV infection is rapidly expanding for the development of dual o triple therapy. The availability of interferon-free combined treatment with direct antiviral agents for HCV is very promising, in order to ameliorate the patient compliance and to reduce the development of thyroid autoimmunity.
Core tip: This review examines the relationship between the hepatitis C virus (HCV) infection and the thyroid autoimmunity, on the basis of recent evidence of the literature about the mechanisms of self tolerance and thyroid damage related to HCV. The advances in the HCV infection treatment have been discussed in the paper, with relevant clinical results.