Abstract

The present study investigated the association of thyroid dysfunction (TD) with the distribution of chronic hepatitis C virus (HCV) infection in untreated patients. A total of 1,012 cases of HCV-infected patients were collected from different regions, of which 209 patients demonstrated a type of TD (chronic thyroiditis complicated with hyperthyroidism, chronic thyroiditis complicated with hypothyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, hyperthyroidism, hypothyroidism or chronic thyroiditis). The results showed the existence of geographical differences in the types of TD present with HCV infection. The female patients had a higher incidence of autoimmune-related TD than the male patients. High levels of HCV RNA expression were most common in all HCV-infected patients, regardless of the presence of TD. High and medium expression levels of HCV RNA were more prevalent in the patients with autoimmune-related TD. Relative analysis of the HCV RNA levels showed that the pathogenesis of TD was not correlated with the HCV RNA expression levels; however, it may have been associated with autoimmunity. The HCV-infected patients with TD were most commonly middle-aged, whereas young adults were the largest group of patients with HCV and normal thyroid function. Among all HCV genotypes, type 1b was the most common HCV genotype and type 2 was the second most common. Types 3 and 6 were scarce in this study population. No associations were identified between HCV genotypes and thyroid disease. The data of liver function showed that HCV-infected patients with TD had a higher liver dysfunction rate compared with that of the patients with normal thyroid function. Therefore, liver dysfunction may be associated with thyroid disease. This study supports the potential of individualized treatment for HCV-infected patients.

Highlights

  • Hepatitis C (HCV) is the principal cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC)

  • The study showed that North (28.3%) and Northwest (26.5%) China accounted for the highest proportions of thyroid dysfunction (TD) in patients with hepatitis C virus (HCV) infection, and the lowest proportions were observed in the patients in Southwest (15.7%), South (14.4%) and Central (17.4%) China

  • Subclinical hypothyroidism had the highest incidence of all the types of TD; the highest proportions of patients with subclinical hypothyroidism were in North (13.0%) and North West (14.2%) China and the lowest proportion was in South China (1.9%)

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Summary

Introduction

Hepatitis C (HCV) is the principal cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC). It was estimated in 2001 that the number of new cases of HCV infection worldwide is >3.5 million per year [1]. In China, a country with a high incidence of HCV infection, there are ~40 million individuals infected with HCV, with a prevalence of ~3.2% [2]. TD is one of the complex diseases common in patients with chronic HCV infection and is triggered by interactions between genetic, epigenetic and microenvironmental factors [5]. The association between the epidemiological factors of HCV infection and possible properties of TD requires investigation in patients with HCV infection. The high incidence of TD in patients with HCV receiving interferon‐α therapy has been well verified in a previous study [6], the correlation between TD and HCV‐infected patients without interferon treatment remains under debate and is explored in the present study

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