Virologic factors related to interferon-α-induced thyroid dysfunction in patients with chronic hepatitis C
Virologic factors related to interferon-α-induced thyroid dysfunction in patients with chronic hepatitis C
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DOI：
10.1530/eje.0.1420431
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发表时间：
2000-05-01
影响因子：
5.8
通讯作者：
Chang, WY
中科院分区：
文献类型：
--
作者：
Hsieh, MC;Yu, ML;Chang, WY
目的：据报道，丙型肝炎病毒（HCV）与丙型肝炎感染患者自身免疫血清学标志物的高流行率有关，并且可能与甲状腺组织抗原的部分氨基酸片段共享，可能与干扰素- α (ifn - α)诱导的慢性丙型肝炎患者甲状腺功能障碍有关。我们进行这项研究是为了澄清这个问题。设计与方法：150例基线甲状腺功能正常的慢性丙型肝炎患者接受ifn - α 2a、2b和n1治疗（3-6百万单位，每周3次，持续24周）。检测预处理血清HCV基因型和HCV RNA水平。血清促甲状腺素、总甲状腺素和游离甲状腺素指数每4周测定一次，连续测定24周，之后每8周测定一次，连续测定24周。结果：21例（14.0%）患者出现早期甲状腺功能障碍（治疗前3个月出现甲状腺功能异常）。女性、较低的HCV RNA水平、ifn - α n1和较低的ifn - α剂量与早期甲状腺功能障碍显著相关。在多变量分析中，性别、ifn - α制备和HCV RNA水平是与早期甲状腺功能障碍相关的重要因素。7例（4.7%）患者在ifn - α治疗的后3个月出现甲状腺功能障碍。总的来说，18.7%的患者出现了甲状腺功能障碍。女性、混合HCV基因型感染和较低的HCV RNA水平与甲状腺功能障碍显著相关。然而，在多变量分析中，只有性别仍然与ifn - α诱导的甲状腺功能障碍显著相关。结论：丙型肝炎病毒病毒学特征可能与干扰素α治疗的慢性丙型肝炎患者甲状腺功能障碍有关。尽管如此，性别在ifn - α诱导的甲状腺功能障碍中仍然起着最重要的作用。
Objective: Hepatitis C virus (HCV), being reported to be associated with a high prevalence of serological markers of autoimmunity in HCV-infected patients, and possibly sharing partial sequences in amino acid segments with thyroid tissue antigens, may be associated with interferon-alpha (IFN-alpha)-induced thyroid dysfunction in chronic hepatitis C patients. We conducted this study to clarify the issue.Design and Methods: One hundred and fifty chronic hepatitis C patients with normal baseline thyroid function were treated with IFN-alpha 2a, 2b and n1 (3-6 million Units three times weekly for 24 weeks). Pretreatment sera were tested for HCV genotype and HCV RNA levels. Serum thyrotropin, total thyroxine and free thyroxine index were performed every 4 weeks for 24 weeks followed by every 8 weeks for another 24 weeks.Results: Twenty-one (14.0%) patients developed early thyroid dysfunction (abnormal thyroid function during the first 3 months of therapy). Female gender, lower HCV RNA levels, IFN-alpha n1 and a lower IFN-alpha dose were significantly associated with early thyroid dysfunction. On multivariate analysis, gender, IFN-alpha preparation and HCV RNA levels were the significant factors associated with early thyroid dysfunction. Seven (4.7%) patients developed thyroid dysfunction during the second 3 months of IFN-alpha therapy. Taken together, 18.7% patients developed thyroid dysfunction. Female, mixed HCV genotype infection and lower HCV RNA levels were significantly associated with thyroid dysfunction. However, only gender remained significantly associated with IFN-alpha-induced thyroid dysfunction in multivariate analysis.Conclusions: The virologic features of HCV may be associated with thyroid dysfunction in chronic hepatitis C patients treated with IFN-alpha. Nevertheless, gender still plays the most important role in IFN-alpha-induced thyroid dysfunction.