Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2015; 21(33): 9765-9773
Published online Sep 7, 2015. doi: 10.3748/wjg.v21.i33.9765
Thyroid dysfunction in Chinese hepatitis C patients: Prevalence and correlation with TPOAb and CXCL10
Ren-Wen Zhang, Cui-Ping Shao, Na Huo, Min-Ran Li, Hong-Li Xi, Min Yu, Xiao-Yuan Xu
Ren-Wen Zhang, Cui-Ping Shao, Na Huo, Min-Ran Li, Hong-Li Xi, Min Yu, Xiao-Yuan Xu, Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
Author contributions: Xu XY designed the research; Zhang RW, Shao CP, Huo N, Li MR, Xi HL and Yu M performed the research; Zhang RW and Shao CP contributed new reagents/analytic tools; Zhang RW analyzed the data; Zhang RW and Xu XY wrote the paper.
Supported by National Major Project for Infectious Diseases Control, No. 2012ZX10002003-004-003; National Natural Science Foundation of China, No. 81373056; PhD Program Foundation of Ministry of Education of China, No. 20090001110081.
Institutional review board statement: The study was reviewed and approved by Peking University People Hospital Institutional Review Board.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Yuan Xu, Professor, Department of Infectious Diseases, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing 100034, China. xiaoyuanxu6@163.com
Telephone: +86-10-83575787
Received: April 9, 2015
Peer-review started: April 9, 2015
First decision: May 18, 2015
Revised: June 2, 2015
Accepted: July 8, 2015
Article in press: July 8, 2015
Published online: September 7, 2015
Processing time: 151 Days and 5.8 Hours
Abstract

AIM: To investigate the relationship among pretreatment serum CXC chemokine ligand 10 (CXCL10), thyroid peroxidase antibody (TPOAb) levels and thyroid dysfunction (TD) in Chinese hepatitis C patients.

METHODS: One hundred and thirty-nine treatment-naive genotype 1 chronic hepatitis C patients with no history of TD or treatment with thyroid hormones were enrolled in this study. Patients underwent peginterferon alfa-2a/ribavirin (PegIFNα-2a/RBV) treatment for 48 wk, followed by detection of clinical factors at each follow-up point. Hepatitis C virus (HCV) antibodies were analyzed using microsomal chemiluminescence, and serum HCV RNA was measured by real-time PCR assay at 0, 4, 12, 24 and 48 wk after the initiation of therapy and 24 wk after the end of therapy. To assess thyroid function, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3) and TPOAb/thyroglobulin antibody (TGAb) levels were determined using chemiluminescent immunoassays every 3 mo. Serum CXCL10 levels were determined at baseline.

RESULTS: The prevalence of TD was 18.0%. Twenty-one (84.0%) out of twenty-five patients exhibited normal thyroid function at week 24 after therapy. The rate of sustained virological response to PegIFNα-2a/RBV in our study was 59.0% (82/139), independent of thyroid function. Pretreatment serum CXCL10 levels were significantly increased in patients with euthyroid status compared with patients with TD (495.2 ± 244.2 pg/mL vs 310.0 ± 163.4 pg/mL, P = 0.012). Patients with TD were more frequently TPOAb-positive than non-TD (NTD) patients (24.2% vs 12.3%, P = 0.047) at baseline. Three of the one hundred and fifteen patients without TPOAb at baseline developed TD at the end of treatment (37.5% vs 2.6%, P = 0.000). Female patients exhibited an increased risk for developing TD compared with male patients (P = 0.014).

CONCLUSION: Lower pretreatment serum CXCL10 levels are associated with TD, and TD prevalence increases in female patients and patients who are positive for TPOAb at baseline.

Keywords: Thyroid dysfunction; Thyroid peroxidase antibody; CXC chemokine ligand 10; Peginterferon alfa-2a/ribavirin; China

Core tip: We present novel data on the influence of peginterferon alfa-2a/ribavirin (PegIFNα-2a/RBV) on thyroid function in Chinese genotype 1 hepatitis C virus (HCV)-infected patients over a 48-wk treatment period. The results demonstrate that the prevalence of thyroid dysfunction (TD) was 18.0%. Lower pretreatment serum CXCL10 levels were associated with PegIFNα-2a/RBV induced TD in genotype 1 HCV-infected patients, and female patients exhibited an increased risk for developing TD compared with male patients. Baseline TPOAb positivity may also be a risk factor for TD development. However, most (84%) of the TD cases were reversible. To our knowledge, this is the first study to investigate the association of CXCL10 levels with PegIFNα-2a/RBV induced TD in genotype 1 HCV-infected patients in China.