Introduction: Chronic hepatitis C has a high incidence in our country being a major public health issue.
Aims and methods: To establish prognostic factors for developing thyroid dysfunction in patients with chronic hepatitis C receiving pegylated interferon and ribavirin therapy. A prospective study of patients with chronic hepatitis C on antiviral therapy was undertaken. 68 patients started on antiviral therapy in the period 1st January 2003 1st January 2005 were enrolled in the study. Patient with pre-existing thyroid pathology were excluded from the study. Patient follow-up occurred at 3, 6, 8 and 12 months after commencement of treatment. Follow-up consisted of thyroid echography, TSH, fT3 and fT4 measurement, as well as anti-thyroid anti-body (anti-thyroglobulin and anti-peroxidase) and anti-TSH receptor antibodies assessment. The patients were divided into two groups: group A patients who developed thyroid dysfunction; group B patients who did not develop thyroid dysfunction. The following parameters were recorded: age, gender, family history of thyroid disease, initial viral load, cytolysis, histology, early viral response and type of interferon used. Viral genotyping was not performed, as Hepatitis C genotype 1b is present in over 90% of cases diagnosed in our country.
Results: 11 patients (16.7%) developed thyroid dysfunction (7 hypothyroid, 4 hyperthyroid), forming group A. The remaining patients (57) formed group B. Statistically significant factors associated with thyroid dysfunction were: female gender (8 patients group A, 29 group B), family history of thyroid disease (6 patients group A, 13 group B), severe hepatic fibrosis (6 patients group A, 19 group B).
Conclusions: Thyroid dysfunction in more common in elderly patients, being associated with female gender, family history of thyroid disease and degree of hepatic fibrosis. Thyroid dysfunction is not associated with initial viraemia, cytolysis, early viral response, type of pegylated interferon used.