Abstract：
OBJECTIVE: Thyroid disorders represent a common side effect of antiviral therapy in patients with chronic hepatitis C (CHC). However, there is strong evidence for a higher prevalence of thyroidal antibodies (TA) and nonorgan-specific autoantibodies (NOSA) even before interferon (IFN) administration. Here, we report for the first time on the distribution and occurrence of TA and NOSA before, during, and after treatment with daily highdosed IFN alfacon-1 [consensus IFN (CIFN)].
METHODS: Thyrotropin (TSH) levels and antibodies to different autoantigens were analyzed in 217 patients with CHC (29.8% females) who were treated with CIFN induction therapy (27 or 18 mg q.d.).
RESULTS: Pretreatment abnormal TSH levels (TSH>3.0 mU/L or <0.4 mU/L) were detected in 15.6% and occurred significantly more often in females (24.6%; P=0.018). TA could be detected only in 2.6%, NOSA in up to 29.9% (47.4% females vs. 24.2% males). During CIFN induction therapy, low TSH levels were detected in 14.1% whereas elevated TSH levels occurred later (week 48) in up to 15.5%, again preferentially in females (42%, P=0.005). In 1.4% of all patients, treatment had to be discontinued because of symptomatic hyperthyroidism. TAs were detected in 10.5% (30.5% females) and NOSA up to 58% during CIFN treatment.
CONCLUSIONS: During CIFN induction therapy, alterations in TSH levels and an increased prevalence of TA and NOSA are quite common, especially in females. Clinically relevant symptoms occur, however, only in a small number (1.4%). Thus, treatment with daily and high-dose CIFN does not appear to increase the incidence of (severe) thyroidal or other autoimmune disorders compared with standard IFN in patients with CHC.
METHODS: Thyrotropin (TSH) levels and antibodies to different autoantigens were analyzed in 217 patients with CHC (29.8% females) who were treated with CIFN induction therapy (27 or 18 mg q.d.).
RESULTS: Pretreatment abnormal TSH levels (TSH>3.0 mU/L or <0.4 mU/L) were detected in 15.6% and occurred significantly more often in females (24.6%; P=0.018). TA could be detected only in 2.6%, NOSA in up to 29.9% (47.4% females vs. 24.2% males). During CIFN induction therapy, low TSH levels were detected in 14.1% whereas elevated TSH levels occurred later (week 48) in up to 15.5%, again preferentially in females (42%, P=0.005). In 1.4% of all patients, treatment had to be discontinued because of symptomatic hyperthyroidism. TAs were detected in 10.5% (30.5% females) and NOSA up to 58% during CIFN treatment.
CONCLUSIONS: During CIFN induction therapy, alterations in TSH levels and an increased prevalence of TA and NOSA are quite common, especially in females. Clinically relevant symptoms occur, however, only in a small number (1.4%). Thus, treatment with daily and high-dose CIFN does not appear to increase the incidence of (severe) thyroidal or other autoimmune disorders compared with standard IFN in patients with CHC.
摘要：
目的：甲状腺疾病是慢性丙型肝炎（CHC）患者抗病毒治疗的常见副作用。然而,有强有力的证据表明,即使在干扰素(IFN)给药之前,甲状腺抗体(TA)和非器官特异性自身抗体(NOSA)的患病率也较高.这里,我们之前首次报道了TA和NOSA的分布和发生情况，during,和每日高剂量IFNalfacon-1[共识IFN（CIFN）]治疗后。
方法：分析了217例接受CIFN诱导治疗（27或18mgq.d.）的CHC患者（29.8％女性）的促甲状腺激素（TSH）水平和针对不同自身抗原的抗体。
结果：治疗前TSH水平异常（TSH>3.0mU/L或<0.4mU/L）的发生率为15.6％，女性发生率明显更高（24.6％；P=0.018）。TA只能在2.6%中检测到，NOSA高达29.9%(47.4%的女性与24.2%男性）。DuringCIFN诱导治疗，TSH水平低检测到14.1%，而TSH水平升高发生在后来(第48周)高达15.5%，再次优先于女性(42%，P=0.005)。在所有患者的1.4%中，由于有症状的甲状腺功能亢进,不得不停止治疗.在CIFN治疗期间，在10.5％（30.5％的女性）和NOSA中检测到高达58％。
结论：持续CIFN诱导治疗，TSH水平的改变以及TA和NOSA的患病率增加是相当普遍的，尤其是女性。出现临床相关症状，然而,只有少数(1.4%)。因此，在CHC患者中,与标准IFN相比,每日和高剂量FN治疗似乎不会增加(严重)甲状腺或其他自身免疫性疾病的发病率.
方法：分析了217例接受CIFN诱导治疗（27或18mgq.d.）的CHC患者（29.8％女性）的促甲状腺激素（TSH）水平和针对不同自身抗原的抗体。
结果：治疗前TSH水平异常（TSH>3.0mU/L或<0.4mU/L）的发生率为15.6％，女性发生率明显更高（24.6％；P=0.018）。TA只能在2.6%中检测到，NOSA高达29.9%(47.4%的女性与24.2%男性）。DuringCIFN诱导治疗，TSH水平低检测到14.1%，而TSH水平升高发生在后来(第48周)高达15.5%，再次优先于女性(42%，P=0.005)。在所有患者的1.4%中，由于有症状的甲状腺功能亢进,不得不停止治疗.在CIFN治疗期间，在10.5％（30.5％的女性）和NOSA中检测到高达58％。
结论：持续CIFN诱导治疗，TSH水平的改变以及TA和NOSA的患病率增加是相当普遍的，尤其是女性。出现临床相关症状，然而,只有少数(1.4%)。因此，在CHC患者中,与标准IFN相比,每日和高剂量FN治疗似乎不会增加(严重)甲状腺或其他自身免疫性疾病的发病率.
