Tran A, Quaranta J F, Benzaken S, Thiers V, Chau H T, Hastier P, Regnier D, Dreyfus G, Pradier C, Sadoul J L
Department of Hepatogastroenterology, Archet Hospital, Nice, France.
Hepatology. 1993 Aug;18(2):253-7.
After describing two cases of Hashimoto's thyroiditis associated with chronic hepatitis C, we set up a prospective study to assess the prevalence of thyroid autoantibodies (thyroglobulin and thyroid microsomal autoantibodies) in 72 chronic hepatitis C patients (43 men and 29 women; mean age = 51 +/- 2.1 yr) before interferon therapy admitted between January and December 1991 to our liver unit. Thyroid autoantibodies were systematically assayed in 60 chronic HBsAg-positive patients (34 men and 26 women; mean age = 50 +/- 2.2 yr), who served as controls. Antibody to hepatitis C virus was detected with a second-generation enzyme immunoassay and then confirmed with a recombinant immunoblot assay and a supplemental enzyme immunoassay using two beads. In chronic hepatitis C patients, no men had thyroid autoantibodies. Nine of 29 women (31%) had thyroid autoantibodies. Among them, six (20.7%) had high titers of thyroid autoantibodies, and two had hypothyroidism. In all nine of these women, hepatitis C virus viremia was detected on nested polymerase chain reaction (with primers located in the 5' untranslated region). One year later, titers of thyroid autoantibodies had increased in one patient. Three other patients progressed to hypothyroidism. We judged four of 29 patients (13.8%) to have Hashimoto's thyroiditis on the basis of their high titers of thyroid autoantibodies and biological features of hypothyroidism. In the control group, only one man had thyroid microsome autoantibodies, at a very low titer (1:100). The association between chronic hepatitis C and presence of thyroid autoantibodies is clearly confirmed (p = 0.021) by this study.
在描述了两例与慢性丙型肝炎相关的桥本甲状腺炎病例后，我们开展了一项前瞻性研究，以评估1991年1月至12月间入住我们肝病科接受干扰素治疗前的72例慢性丙型肝炎患者（43例男性和29例女性；平均年龄 = 51±2.1岁）中甲状腺自身抗体（甲状腺球蛋白和甲状腺微粒体自身抗体）的患病率。对60例慢性HBsAg阳性患者（34例男性和26例女性；平均年龄 = 50±2.2岁）进行了甲状腺自身抗体的系统检测，这些患者作为对照。采用第二代酶免疫测定法检测丙型肝炎病毒抗体，然后用重组免疫印迹测定法和使用两颗珠子的补充酶免疫测定法进行确认。在慢性丙型肝炎患者中，没有男性有甲状腺自身抗体。29名女性中有9名（31%）有甲状腺自身抗体。其中，6名（20.7%）甲状腺自身抗体滴度高，2名有甲状腺功能减退。在所有这9名女性中，通过巢式聚合酶链反应（引物位于5'非翻译区）检测到丙型肝炎病毒血症。一年后，1例患者的甲状腺自身抗体滴度升高。另外3例患者发展为甲状腺功能减退。基于其高滴度的甲状腺自身抗体和甲状腺功能减退的生物学特征，我们判定29例患者中有4例（13.8%）患有桥本甲状腺炎。在对照组中，只有1名男性有甲状腺微粒体自身抗体，滴度非常低（1:100）。这项研究明确证实了慢性丙型肝炎与甲状腺自身抗体存在之间的关联（p = 0.021）。
