This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (22)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Viral Infections  • Otolaryngology/ Head & Neck Surgery  • Endocrine Disease of Head & Neck  • Adverse Effects  • Thyroid/ Parathyroid Diseases  • Liver/ Biliary Tract/ Pancreatic Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

A Prospective Cohort Study

Edmund J. Bini, MD, MPH; Saurabh Mehandru, MD

Arch Intern Med. 2004;164:2371-2376.

Background  Thyroid dysfunction is a known complication of interferon monotherapy in women with hepatitis C virus (HCV) infection. The aims of this study were to determine the incidence and long-term outcome of thyroid dysfunction in HCV-infected men receiving interferon and ribavirin combination therapy.

Methods  We prospectively studied 225 HCV-infected men with baseline levels of thyrotropin (TSH) within the reference range who were treated with subcutaneous interferon alfa-2b (3 million units 3 times per week) and oral ribavirin (1000-1200 mg/d) for 24 to 48 weeks. Patients underwent screening of TSH levels every 12 weeks during HCV therapy and at weeks 12 and 24 after completion of treatment. Patients with abnormal TSH levels underwent a comprehensive thyroid evaluation.

Results  Among the 225 patients, overt thyroid disease developed in 6.7% (95% confidence interval, 3.8%-10.8%), and subclinical thyroid disease was diagnosed in 4.0% (95% confidence interval, 1.8%-7.4%). In the 12 patients with overt hypothyroidism, antithyroglobulin antibodies were present in 11 and antithyroid peroxidase antibodies were present in 10, whereas thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals with overt hyperthyroidism. Most of the patients with thyroid dysfunction completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9 with subclinical thyroid disease.

Conclusions  Men with HCV infection treated with interferon and ribavirin should undergo routine screening for thyroid disease. Treatment of HCV can be safely continued in these patients because thyroid disease responds well to treatment and is reversible in most individuals.

Author Affiliations: Department of Medicine and Division of Gastroenterology, Veterans Affairs New York Harbor Healthcare System and New York University School of Medicine, New York.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

The Uncertain Natural History of Thyrotoxic Patients Treated With Combination Interferon Alfa-2 and Ribavirin
Huy A. Tran
Arch Intern Med. 2005;165(9):1072.
EXTRACT | FULL TEXT  

The Uncertain Natural History of Thyrotoxic Patients Treated With Combination Interferon Alfa-2 and Ribavirin—Reply
Saurabh Mehandru and Edmund J. Bini
Arch Intern Med. 2005;165(9):1072-1073.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk of Non-Hodgkin Lymphoma and Lymphoproliferative Precursor Diseases in US Veterans With Hepatitis C Virus
Giordano et al.
JAMA 2007;297:2010-2017.
ABSTRACT | FULL TEXT  

Update in Endocrinology
Wartofsky
ANN INTERN MED 2005;143:673-682.
FULL TEXT  

The Uncertain Natural History of Thyrotoxic Patients Treated With Combination Interferon Alfa-2{beta} and Ribavirin
Tran
Arch Intern Med 2005;165:1072-1072.
FULL TEXT  

The Uncertain Natural History of Thyrotoxic Patients Treated With Combination Interferon Alfa-2{beta} and Ribavirin--Reply
Mehandru and Bini
Arch Intern Med 2005;165:1072-1073.
FULL TEXT