Thyroid dysfunction ribavirin

The occurrence of thyroid dysfunction in 72 patients treated with interferon alfa plus ribavirin (1.0-1.2 g/day) has been compared with that of 75 age- and sex-matched patients treated with interferon alfa alone for chronic hepatitis C (523). Of the former, 42 patients, and of the latter, 40 patients had received previous treatment with interferon alfa alone. There was no difference in the rate of thyroid autoimmunity (antithyroglobulin, antithyroid peroxidase, and thyroid-stimulating hormone receptor... 

Endocrine In a retrospective study of 260 patients who received interferon-I-ribavirin for hepatitis C infection 10% developed a suppressed serum TSH (0.8% Graves disease, 9.6% transient thyroiditis) and 12% developed a raised serum TSH 1.5% developed permanently hypothyroidism and requiring levothyroxine [49 ]. Women had a relative risk of thyroid dysfunction of 1.96 (95% Cl = 1.8, 3.0). A serum TSH of 1.75 mU/1 or more and a positive thyroid peroxidase antibody titer before therapy were associated with relative risks of 6.0 (95% Cl=3.0, 13) and 4.4 (95% Cl = 2.6, 6.5) respectively. The combination of baseline TSH and thyroid peroxidase antibody data predicted progression to thyroid dysfunction with a sensitivity of 95%. 

Costelloe SJ, Wassef N, Schulz J, Vaghijiani T, Morris C, Whiting S, Thomas M, Dusheiko G, Jacobs M, Vanderpump MP. Thyroid dysfunction in a UK hepatitis C population treated with interferon-alpha and ribavirin combination therapy. Clin Endocrinol (Oxf) 2010 73(2) 249-56. 

Endocrine Of 107 patients with non-cir-rhotic chronic hepatitis C, who were given interferon plus ribavirin for 24 weeks, 20 developed thyroid dysfunction compared with 60 controls awaiting treatment [30 ]. Women were at a higher risk (RR = 11). Hypothyroidism was more common than hyperthyroidism. 

In a prospective study, the overall incidence of biochemical thyroid disorders was 12% in 254 patients with chronic hepatitis C randomized to receive ribavirin plus high-dose interferon alfa (6 MU/day for 4 weeks then 9 MU/week for 22 weeks) or conventional treatment (9 MU/week for 26 weeks) (165). There was no difference in the incidence or the time to occurrence of thyroid disorders between the groups. Of the 30 affected patients, 11 (37%) had positive thyroid peroxidase autoantibodies (compared with 1% of patients without thjroid dysfunction), nine developed symptomatic thjroid dysfunction, and only three had to discontinue treatment. There was no correlation between the viral response and the occurrence of thyroid disorders, and only female sex and Asian origin were independent predictors of thyroid disorders. 

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