Hepatit C veya interferon tedavisi ile ilişkili tiroit hastalıkları

Karaciğer dışı birçok hastalık kronik hepatit C virüs (HCV) enfeksiyonu (hematolojik hastalıklar, böbrek hastalığı, dermatolojik problemler) ile ilişkilendirilmiştir. HCV enfeksiyonunun klinik ya da subklinik oto-immün tiroid hastalıklarının artmış insidansıyla da ilişkili olduğu gösterilmiştir. Ayrıca, kronik HCV enfeksiyonunun interferon (IFN)-? ile tedavisi vakaların % 40'ına kadar olan kısmında subklinik veya klinik tiroidit ile ilişkilidir. İnterferon ilişkili tiroidit (İİT), otoimmüntip ve otoimmün olmayan tip olarak sınıflandırılabilir. Mevcut çalışmalar viral yük, viral genotip ve tedavi rejiminin kronik hepatit C hastalarında İİT gelişimini etkilemediğini, ayrıca İİT gelişmesinin kalıcı viral yanıt (KVY) için bir gösterge olmadığını, ancak, genetik faktörler, cinsiyet, HCV enfeksiyonu ve tiroid antikor (TAb) pozitifliğinin rol oynayabileceğini göstermektedir.

Thyroid disorders associated with hepatitis C or interferon based therapies

Several extrahepatic diseases have been associated with chronic hepatitis C virus (HCV) infection (i.e. hematologic diseases, renal disease, dermatologic conditions). It has also been shown that HCV infection is associated with increased incidence of clinical and subclinical autoimmune thyroid disorders. Moreover, interferon (IFN)-? therapy of chronic HCVinfection is associated with subclinical or clinical thyroiditis in up to 40% of cases. Interferon induced thyroiditis (IIT) can be classified as autoimmune type and non-autoimmune type. Current studies indicate that viral load, viral genotype and therapeutic regimen do not influence development of IIT in chronic hepatitis C patients thus, and development of IIT is not a predictor of sustained viral response. However, evidence suggests that genetic factors, gender, HCV infection and positivity of thyroid antibodies may play role. J Microbiol Infect Dis 2013; 3(3): 147-149

___

  • 1. Andrade LJ, Atta AM, D'Almeida Junior A, Paraná R. Thyroid dysfunction in hepatitis C individuals treated with interferonalpha and ribavirin-a review. Braz J Infect Dis 2008; 12:144- 148.
  • 2. Tomer Y. Hepatitis C and interferon induced thyroiditis. J Autoimmun 2010; 34:322-326.
  • 3. Antonelli A, Ferri C, Pampana A, et al. Thyroid disorders in chronic hepatitis C. Am J Med 2004; 117:10-13.
  • 4. Indolfi G, Stagi S, Bartolini E, et al. Thyroid function and antithyroid autoantibodies in untreated children with vertically acquired chronic hepatitis C virus infection. Clin Endocrinol 2008;68:117-121.
  • 5. Antonelli A, Ferri C, Fallahi P, et al. Thyroid disorders in chronic hepatitis C virus infection. Thyroid. 2006; 16:563-572.
  • 6. Tomer Y, Villanueva R. Hepatitis C and thyroid autoimmunity: is there a link? Am J Med. 2004; 117:60-61.
  • 7. Mandac JC, Chaudhry S, Sherman KE, Tomer Y. The clinical and physiological spectrum of interferon-alpha induced thyroiditis: toward a new classification. Hepatology 2006; 43:661-672.
  • 8. Tomer Y, Menconi F. Interferon induced thyroiditis. Best Pract Res Clin Endocrinol Metab 2009; 23:703-712.
  • 9. Danilovic DL, Mendes-Correa MC, Chammas MC, Zambrini H, Marui S. Thyroid hormonal disturbances related to treatment of hepatitis C with interferon-alpha and ribavirin. Clinics (Sao Paulo) 2011; 66:1757-1763.
  • 10. Barut S, Gunal O, Erkorkmaz U, Yildiz F. Thyroid dysfunction in Turkish patients with chronic hepatitis C receiving peginterferon plus ribavirin in the period of 2005-2010. Braz J Infect Dis. 2012; 16:448-451.
  • 11. Yan Z, Fan K, Fan Y, et al. Thyroid dysfunction in Chinese patients with chronic hepatitis C treated with interferon alpha: incidence, long-term outcome and predictive factors. Hepat Mon. 2012; 12:e6390.
  • 12. Tran HA, Reeves GE, Jones TL. The natural history of interferon-alpha2b-induced thyroiditis and its exclusivity in a cohort of patients with chronic hepatitis C infection. QJM 2009;102:117-122.
  • 13. Vezali E, Elefsiniotis I, Mihas C, et al. Thyroid dysfunction in patients with chronic hepatitis C: virus-or therapy-related? J Gastroenterol Hepatol 2009;24:1024-1029.
  • 14. Sünbül M, Şahbat E, Akkuş M, Esen Ş, Kahraman H, Leblebicioğlu H. Evaluation of thyroid functions during interferon-alpha treatment of patients with chronic viral hepatitis. Viral Hepatit Dergisi 2004;9:67-71. (In Turkish)
  • 15. Watanabe U, Hashimoto E, Hisamitsu T, Obata H, Hayashi N. The risk factor for development of thyroid disease during interferon-alpha therapy for chronic hepatitis C. Am J Gastroenterol 1994; 89:399-403.
  • 16. Roti E, Minelli R, Giuberti T, et al. Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha. Am J Med 1996;101:482- 487.
  • 17. Tran HA, Malcolm Reeves GE, Gibson R, Attia JR. Development of thyroid diseases in the treatment of chronic hepatitis C with alpha-interferon may be a good prognosticator in achieving a sustained virological response: A meta-analysis. J Gastroenterol Hepatol. 2009;24:1163-1168.