Thyroid dysfunction in a UK hepatitis C population treated with interferon-α and ribavirin combination therapy
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...
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| Published in | Clinical endocrinology (Oxford) Vol. 73; no. 2; pp. 249 - 256 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.08.2010
Blackwell |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0300-0664 1365-2265 1365-2265 |
| DOI | 10.1111/j.1365-2265.2010.03785.x |
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| Abstract | 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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| AbstractList | 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. To assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with interferon-alpha (IFNalpha) and ribavirin combination therapy (IFN/RBV).OBJECTIVETo assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with interferon-alpha (IFNalpha) and ribavirin combination therapy (IFN/RBV).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.DESIGN, PATIENTS AND MEASUREMENTSA 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.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 > or =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%.RESULTSFull 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 > or =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%.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.CONCLUSIONSAlthough 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. 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. To assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with interferon-alpha (IFNalpha) and ribavirin combination therapy (IFN/RBV). 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. 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 > or =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%. 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. |
| Author | Costelloe, Seán J. Morris, Catherine Jacobs, Michael Whiting, Stephen Thomas, Michael Schulz, Josephine Dusheiko, Geoffrey Vaghijiani, Tina Wassef, Nancy Vanderpump, Mark P. J. |
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| Keywords | Endocrinopathy Human Drug combination Alpha interferon Thyroid diseases Hepatic disease Ribavirin Infection Viral hepatitis A Thyroid function Viral disease Nucleoside analog Digestive diseases Antiviral Population Combined treatment Endocrinology Viral hepatitis C |
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Objective To assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with... 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... To assess the incidence of thyroid dysfunction (TD) in a UK cohort of patients with hepatitis C virus (HCV) infection treated with interferon-alpha (IFNalpha)... |
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| SubjectTerms | Adult Age of Onset Antiviral Agents - administration & dosage Antiviral Agents - adverse effects Biological and medical sciences Drug Therapy, Combination - adverse effects Endocrinopathies Female Fundamental and applied biological sciences. Psychology Hepatitis C - drug therapy Hepatitis C - epidemiology Human viral diseases Humans Infectious diseases Interferon-alpha - administration & dosage Interferon-alpha - adverse effects Male Medical sciences Middle Aged Non tumoral diseases. Target tissue resistance. Benign neoplasms Retrospective Studies Ribavirin - administration & dosage Ribavirin - adverse effects Thyroid Diseases - chemically induced Thyroid Diseases - epidemiology Thyroid. Thyroid axis (diseases) United Kingdom - epidemiology Vertebrates: endocrinology Viral diseases Viral hepatitis |
| Title | Thyroid dysfunction in a UK hepatitis C population treated with interferon-α and ribavirin combination therapy |
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