THYROID DYSFUNCTION IN PATIENTSWITH CHRONIC HEPATITIS B PRIOR AND AFTER THE THERAPYWITH PEGINTERFERON α 2A 180 μg
Abstract:
Objectives of the study: 1. Monitoring the evolution of 125 patients with chronic hepatitis B treated with Peginterferon α 2A, 180 μg/week, in order to establish the occurrence of thyroid disfunctions in the course of this particular treatment; 2. Finding correlations between patients’ clinical and epidemiological parameters (age, gender, level of disease activity, the potential moment of infection and the occurrence of clinical and biological modification of the thyroid). Methods: The prospective clinical study was conducted on a sample of 125 patients with chronic hepatitis B, aged 18-65 years old. Study period: 6 years. Patient monitoring was performed by determining antithyroid antibodies to identify autoimmune thyroiditis, or TSH, T3 and T4, at the beginning of the therapy, and then quarterly. Results: Of 125 patients with chronic active hepatitis with HBV included in the study, 9.6% of patients had positive antithyroid antibodies at the end of therapy, 7.2% had changes of hypothyroidism and 1.6% hyperthyroidism change. Patients with hypothyroidism at the end of therapy had late positive antithyroid antibodies. Dose reduction of Peginterferon during therapy in the context of iatrogenic haematological changes in patients with positive antithyroid antibodies led to their disappearance. Regarding HBV chronic active hepatitis, there were no significant differences in thyroid dysfunction secondary to a weekly treatment with Interferon α therapy 2A 9 MIU x 3 / week. Patients should be monitored at least 6 months after treatment to prevent worsening of thyroid dysfunction. No significant differences were found on the occurrence of thyroid changes in HBeAg-positive to HBeAg-negative ones. Conclusion: The incidence of thyroid dysfunction in patients with chronic hepatitis B, in most studies, does not differ considerably from the native population.
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