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274 PREVALENCE AND RISK FACTORS OF THYROID DISEASE IN PATIENTS TREATED FOR HEPATITIS C VIRUS HA Wiesinger1, A Ramji2, L Halparin2, R Enns2, H Chaun2, S Whittaker2, B McDougall2 An increased incidence of thyroid disease in patients with hepatitis C treated with interferon-alpha monotherapy or combination with ribavirin for has been described. However predictive factors for developing thyroid complications in this population is not well described, particularly when using pegylated interferon in combination with ribavirin.
1Department of Internal Medicine, 2Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia
OBJECTIVE: To determine the prevalence and predictive factors of thyroid disease in patients with hepatitis C treated with combination pegylated interferon/ribavirin compared to those treated with an interferon-alpha/ribavirin combination.
METHODS: A retrospective analysis of all hepatitis C patients treated with combination pegylated interferon-alpha2b and ribavirin or interferon-alpha/ribavirin from 1995 to 2005 at a tertiary care centre was conducted. Patients were separated into two groups: (a) those with no thyroid abnormalities during therapy; and (b) patients with a change from normal to abnormal TSH levels, or those requiring treatment for either hyper- or hypothyroidism. The two groups were compared for predictive factors including: demographics, HCV genotype, stage of disease, and therapy type.
RESULTS: Of 137 patients, 26 (19%) developed abnormal TSH during their treatment. Eight of these patients required treatment for either hyper- or hypothyroidism. Twenty two of 26 patients (85%) developed thyroid abnormalities within the first 24 weeks of treatment, with 38% occurring in the first 12 weeks. Females were affected more than males (31.6% vs 14.1%, respectively, p=0.02). Thyroid dysfunction occurred more frequently in patients treated with pegylated interferon than those treated with a non-pegylated formulation (27.1% vs 12.8%, respectively, p=0.035). Genotype, biopsy stage and response to treatment were not predictive of thyroid abnormalities.
CONCLUSIONS: Thyroid abnormalities with interferon treatment of HCV are common, occurring in 19% of patients, with 38% developing in the first 12 weeks of therapy. Female gender and treatment with pegylated interferon are predictive of thyroid abnormalities in our patient population.