Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University, Tokat, Turkey.
Braz J Infect Dis. 2012 Sep-Oct;16(5):448-51. doi: 10.1016/j.bjid.2012.05.002. Epub 2012 Sep 7.
Interferon-α based therapy for chronic hepatitis C (CHC) is associated with thyroiditis and thyroid dysfunction (TD). This study investigated whether TD during pegylated interferon-α (PEG-IFN) plus ribavirin treatment favors sustained viral response (SVR), and also the association between TD and PEG-IFN formulations. This retrospective study was performed in CHC patients who had received PEG-IFN plus ribavirin and had been followed for six months after treatment. Several factors were compared between patients with and without TD. 119 patients were included in the study. De novo incidence of TD was found to be 16.8%, and 16 of the 18 patients with TD achieved SVR. Although this rate was higher than patients without TD according to univariate analysis, logistic regression analysis revealed that there was not a significant association between TD and SVR, whereas baseline thyroperoxidase antibody (anti-TPO) positivity was the only significant predictor of TD. Moreover, TD was not associated with PEG-IFN type. Both interferon-α and hepatitis C virus (HCV) contribute to TD during antiviral therapy. It seems that there is no association between thyroid toxicity and viral clearance or type of PEG-IFN; however, anti-TPO positivity before treatment is the strongest predictor for TD during antiviral therapy.
基于干扰素-α的慢性丙型肝炎（CHC）治疗与甲状腺炎和甲状腺功能障碍（TD）有关。本研究旨在探讨聚乙二醇干扰素-α（PEG-IFN）联合利巴韦林治疗期间的 TD 是否有利于持续病毒应答（SVR），并研究 TD 与 PEG-IFN 制剂之间的关系。这项回顾性研究纳入了接受 PEG-IFN 联合利巴韦林治疗并在治疗结束后随访 6 个月的 CHC 患者。比较了 TD 患者和无 TD 患者的各项因素。本研究共纳入 119 例患者。TD 的新发发病率为 16.8%，18 例 TD 患者中有 16 例获得了 SVR。虽然根据单因素分析，TD 患者的 SVR 率高于无 TD 患者，但 logistic 回归分析显示，TD 与 SVR 之间无显著相关性，而基线甲状腺过氧化物酶抗体（anti-TPO）阳性是 TD 的唯一显著预测因素。此外，TD 与 PEG-IFN 类型无关。干扰素-α和丙型肝炎病毒（HCV）在抗病毒治疗期间都可能导致 TD。似乎甲状腺毒性与病毒清除或 PEG-IFN 类型之间没有关联；然而，治疗前的 anti-TPO 阳性是抗病毒治疗期间 TD 的最强预测因素。
