Abstract
BackgroundThis study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan.MethodsThe data in this study were obtained from the Taiwan National Health Insurance Research (Taiwan NHIR) database between 2001 and 2013. CHC patients treated with pegylated interferon/ribavirin (PEG-IFN/RBV) were enrolled as case patients, and nontreated CHC patients were enrolled as controls and were matched at a control:case ratio of 3:1 by index date, age (± 3 years), and sex. We compared the cumulative incidence of TD between the cohorts at follow-up until 2013.ResultsDuring the study period, 3810 cases and 9393 controls were included in the study. Among the study subjects, 173 (4.5%) case patients and 244 (2.6%) controls were diagnosed with TD during the follow-up period. The types of TD were hypothyroidism (42.9%), hyperthyroidism (31.2%), and thyroiditis (25.9%). Compared to controls during the 13-year follow-up, patients treated with PEG-IFN/RBV had a higher incidence rate of TD (P < 0.0001), as determined using the Kaplan-Meier method. Cox proportional hazards regression analysis showed that female sex (adjusted hazard ratio (HR): 1.49; 95% confidence interval (CI): 1.23–1.75; P < 0.001), treatment with PEG-IFN/RBV (HR: 1.68; 95% CI: 1.38–2.06; P < 0.001), hyperlipidemia (HR: 1.38; 95% CI: 1.12–1.71; P < 0.001), and past history of goiter (HR: 6.40; 95% CI: 5.00–8.18; P < 0.001) were independent predictors for the development of TD.ConclusionsPEG-IFN/RBV treatment may be an independent risk factor for thyroid dysfunction among patients with hepatitis C virus (HCV) infection. Monitoring thyroid function keenly during PEG-IFN/RBV therapy in patients with chronic HCV infection is recommended for clinicians, especially for female patients and for patients with a history of hyperlipidemia and goiter.
Highlights
This study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan
This study is based on data from the National Health Insurance Research (NHIR) database provided by the Taiwan National Health Research Institute
A previous study indicated that the most commonly recognized TDs among CHC patients treated with PEG-IFN/ RBV were hyperthyroidism (45.5%), hypothyroidism (33.8%), thyroiditis (19.5%), and goiter (1.3%) [29]
Summary
This study aimed to investigate the occurrence and risk factors of thyroid dysfunction (TD) in patients with chronic hepatitis C (CHC) infection in Taiwan. 3% of the world’s population suffers from hepatitis C virus (HCV) infection, and approximately 70% of HCV patients will develop chronic hepatitis C (CHC) [1]. HCV is both a hepatotropic and lymphotropic virus Both the liver and various nonhepatic tissues and organs may be affected during infection with HCV [1, 2]. Immunological reactions as well as virus invasion and replication in the affected extrahepatic tissues and organs are the main extrahepatic manifestations of HCV infection [6]. Previous studies have demonstrated that there is a high risk for thyroid autoimmunity and thyroid dysfunction (TD) in patients with HCV infection [7, 8]
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