Thyroid Peroxidase Antibodies and Thyroid Dysfunction in Patients with Chronic Hepatitis C Treated with Conventional Interferon and Ribavirin
Keywords:Chronic hepatitis C, Interferon alpha, Interferon-induced thyroid disorders, Thyroid disorder
Objective: To determine the frequency of thyroid dysfunction among patients with chronic hepatitis C receiving Conventional Interferon and Ribavirin combination therapy and to compare the frequency of thyroid dysfunction among patients with thyroid peroxidase positive and negative antibodies among these patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Gastroenterology Department of Medicine, Combined Military Hospital, Lahore Pakistan, from Jan to Jul 2017.
Methodology: Patients reporting chronic hepatitis C, fulfilling the required selection criteria, and received conventional Interferon and Ribavirin therapy were included. A thyroid Function test was performed at enrollment, week-12 and week- 24. The outcome was measured at week 24 by the end of treatment. Anti-Thyroid Peroxidase antibody level was measured at the time of enrollment.
Results: One hundred and fifty-seven patients were enrolled in the study. There was no difference in demographic data comparison. At the end of therapy, 5 (29.41%) male patients and 12 (70.59%) female patients developed TD, with the p-value of 0.019, which is statistically significant. 28 (17.83%) out of 157 patients had positive anti-TPO at baseline. The inferential analysis showed that there were significantly higher positive rates of pre-treatment anti-TPO in patients with TD (16 (94.11%) out of 17) when compared with patients with normal baseline anti-TPO (1 (5.89%) of 17), with the p-value of 0.001.
Conclusion: Pre-treatment anti-Thyroid Peroxidase antibodies and female gender are the most significant risk factors for developing Thyroid Dysfunction during Interferon and Ribavirin therapy.