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The Uncertain Natural History of Thyrotoxic Patients Treated With Combination Interferon Alfa-2 and Ribavirin—Reply

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In reply

We appreciate Dr Tran’s interest in our article¹ and welcome this opportunity to clarify the issues raised by him. Exclusion criteria for our study included a personal history of thyroid disease as well as current or prior treatment of thyroid disease. In addition, baseline thyrotropin (TSH) levels were obtained on all study subjects at week 0. Patients with abnormal TSH levels were excluded from the study.

We agree that there is a lack of consensus regarding how to screen or how often to screen for thyroid disease during interferon and ribavirin therapy. Some authors have suggested that screening for thyroid disease with a complete history and physical examination, TSH levels, and antithyroid peroxidase antibodies should be performed in all patients with hepatitis C virus (HCV) infection prior to therapy.² In addition, these authors recommended treatment of thyroid disease followed by TSH levels every 2 to 6 months during . . . [Full Text of this Article]

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

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