ORIGINAL ARTICLE

Thyroid dysfunction in a UK hepatitis C population treated with interferon-α and ribavirin combination therapy

  1. Seán J. Costelloe1,
  2. Nancy Wassef1,
  3. Josephine Schulz2,
  4. Tina Vaghijiani3,
  5. Catherine Morris4,
  6. Stephen Whiting1,
  7. Michael Thomas1,
  8. Geoffrey Dusheiko2,
  9. Michael Jacobs5,
  10. Mark P. J. Vanderpump4

Article first published online: 10 FEB 2010

DOI: 10.1111/j.1365-2265.2010.03785.x

Issue

Clinical Endocrinology

Clinical Endocrinology

Volume 73, Issue 2, pages 249–256, August 2010

Additional Information

How to Cite

Costelloe, S. J., Wassef, N., Schulz, J., Vaghijiani, T., Morris, C., Whiting, S., Thomas, M., Dusheiko, G., Jacobs, M. and Vanderpump, M. P. J. (2010), Thyroid dysfunction in a UK hepatitis C population treated with interferon-α and ribavirin combination therapy. Clinical Endocrinology, 73: 249–256. doi: 10.1111/j.1365-2265.2010.03785.x

Author Information

  1. 1

    Department of Clinical Biochemistry

  2. 2

    Centre for Hepatology

  3. 3

    Pharmacy Department

  4. 4

    Department of Endocrinology

  5. 5

    Infectious Diseases Unit, The Royal Free Hampstead NHS Trust, Pond Street, London, United Kingdom

*Dr Mark Vanderpump, Department of Endocrinology, Royal Free Hampstead NHS Trust, Pond Street, London NW3 2QG, United Kingdom. Tel.: +44 20 7472 6280; Fax: +44 20 7472 6487; E-mail: mark.vanderpump@royalfree.nhs.uk

Publication History

  1. Issue published online: 21 JUL 2010
  2. Article first published online: 10 FEB 2010
  3. (Received 26 August 2009; returned for revision 4 January 2010; accepted 6 January 2010)

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Summary

Objective  To assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with interferon-α (IFNα) and ribavirin combination therapy (IFN/RBV).

Design, patients and measurements  A retrospective study of 288 patients who received IFN/RBV for HCV during a 2-year period from January 2006 was performed. Thyroid function was assessed during a 24-week or 48-week course of IFN/RBV. If serum thyrotrophin (TSH) became undetectable (<0.01 mU/l) and serum free thyroxine (T4) was raised, a diagnostic thyroid isotope scan was performed.

Results  Full medical records were examined for 260 patients (172 men, 88 women) included in the study, of whom 22.3% (16.9% of men, 33.0% of women) developed TD during IFN/RBV. In total, 10.4% developed a suppressed serum TSH (0.8% Graves’ disease, 9.6% transient thyroiditis) while 11.9% developed an elevated serum TSH with 1.5% becoming permanently hypothyroid and requiring levothyroxine therapy. Women had a relative risk (RR) for developing TD of 1.96 (CI: 1.75–3.03, P = 0.004). A serum TSH ≥1.75 mU/l and a positive thyroid peroxidase (TPO) antibody titre pretherapy were associated with RRs for progression to TD of 6.02 (CI: 2.95–12.78, P < 0.0001) and 4.35 (CI: 2.58–6.52; P < 0.0001), respectively, while combination of baseline TSH and TPO antibody data predicted progression to TD with a sensitivity of 94.7%.

Conclusions  Although TD was common in this cohort, just 2.3% developed TD that required ongoing therapy. Pre-IFN/RBV serum TSH and TPO antibody titre were found to predict progression to TD in this group of patients.

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