FREQUENCY OF THYROID DYSFUNCTION DURING TFT IN INTERFERON AND RIBAVIRIN THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C

TFT in Interferon and Ribavirin Therapy

Abstract

Objective: To determine the frequency of thyroid dysfunction among patients of chronic hepatitis C (HCV) infection receiving combination of interferon-alpha and ribavirin therapy.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Medicine, PNS Shifa Naval Hospital Karachi, from September 2012 to March 2013 over a period of six months.

Patients and Methods: In this study, 170 diagnosed patients of chronic HCV (confirmed by anti-HCV and HCV RNA-positive) presenting to medical OPD with normal thyroid functions were recruited. All patients fulfilled inclusion and exclusion criteria. They were prescribed IFN-alpha 2b (3 million units subcutaneously 3 days a week) and oral preparation of antiviral drug ribavirin (800 to 1200 mg daily in divided doses according to weight). At the end of 12 weeks of combination antiviral therapy, their thyroid profile was worked up. Serum TSH, free T4 and T3 levels were determined by chemiluminescence technique in chemical pathology lab of the hospital. Statistical analysis was done on SPSS 17.

Results: Out of 170 patients, 83 (48.82%) were females and 87 (51.18%) were males with the age ranging from 22–46 years (mean ± SD: 33.86 ± 5.32). After 12 weeks of antiviral therapy, thyroid functions were normal in 156/170 (91.76%) patients, whereas in 14/170 (8.24%) cases thyroid dysfunction was observed. Out of those patients having thyroid dysfunction, 10/14 (71.42%) were hypothyroid whereas 4/14 (28.58%) had hyperthyroidism.

Conclusion: Managing patients of chronic HCV with combination antiviral therapy comprising IFN-alpha 2b and ribavirin can cause thyroid dysfunction. These patients should be monitored before and during treatment to avoid complications and poor compliance.