Ganne-Carrie N, Medini A, Coderc E, Seror O, Christidis C, Grimbert S, Trinchet J C, Beaugrand M
Department of Hepato-gastroenterology, Hospital Jean Verdier, Bondy, 93140, France.
J Autoimmun. 2000 Mar;14(2):189-93. doi: 10.1006/jaut.1999.0360.
In order to establish a relationship between Hepatitis C virus (HCV) chronic infection and autoimmune thyroiditis, 97 untreated patients with biopsy-proven HCV chronic hepatitis and 97 controls were studied. An ultrasound examination of the thyroid and an assay of serum thyroid-stimulating hormone (TSH), thyroid hormones and anti-thyroid antibodies were performed in all cases. The overall prevalence of thyroid abnormalities was higher in patients than in controls (17 vs. 4%, P<0.01) and the prevalence of anti-thyroid antibodies was significantly different between the two groups (P<0. 02). HCV patients with (n=13) compared to HCV patients without anti-thyroid antibodies (n=84) were older, predominantly female, and more frequently had increased serum TSH levels or a hypoechogenic pattern of the thyroid gland, while Knodell's score and prevalence of cirrhosis were similar. Latent autoimmune thyroiditis is more frequent in untreated HCV patients than in controls. This finding raises questions about the mechanism of autoimmunity induced by HCV and provides an explanation for the high rate of overt autoimmune thyroiditis during interferon treatment in these patients.
为了建立丙型肝炎病毒（HCV）慢性感染与自身免疫性甲状腺炎之间的关系，我们对97例经活检证实为HCV慢性肝炎的未治疗患者和97例对照进行了研究。所有病例均进行了甲状腺超声检查以及血清促甲状腺激素（TSH）、甲状腺激素和抗甲状腺抗体检测。患者甲状腺异常的总体患病率高于对照组（17%对4%，P<0.01），两组抗甲状腺抗体的患病率有显著差异（P<0.02）。与无抗甲状腺抗体的HCV患者（n=84）相比，有抗甲状腺抗体的HCV患者（n=13）年龄更大，以女性为主，血清TSH水平升高或甲状腺低回声模式更为常见，而Knodell评分和肝硬化患病率相似。潜伏性自身免疫性甲状腺炎在未治疗的HCV患者中比在对照组中更常见。这一发现引发了关于HCV诱导自身免疫机制的问题，并为这些患者在干扰素治疗期间明显的自身免疫性甲状腺炎的高发生率提供了解释。
