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Órgano Oficial de la Asociación Mexicana de Hepatología

2008, Number 1

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Ann Hepatol 2008; 7 (1)

Thyroid dysfunction (TD) among chronic hepatitis C patients with mild and severe hepatic fibrosis

Rodríguez-Torres M; Ríos-Bedoya CF; Ortiz-Lasanta G; Marxuach-Cuétara AM; Jiménez-Rivera

Language: Spanish
References: 40
Page: 72-77
PDF size: 124.28 Kb.


Text Extraction

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.


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