Prevalence of autoantibodies and the risk of autoimmune thyroid disease in children with chronic hepatitis C virus infection treated with interferon-α

Table 1 Epidemiological, clinical, and biochemical baseline data for HCV-infected patients who underwent either IFN-α monotherapy or combined therapy with IFN-α or peginterferon-α plus ribavirin

	IFN-α(n = 21)	IFN-α +ribavirin(n = 40)	Peginterferon-α+ ribavirin(n = 62)
Male/female ( n )	12/9	19/21	29/33
Median age, yr (range)	9.5 (2-17)	8.1 (2-16)	10.6 (2-17)
Route of infection, n (%)
Parenteral	12 (57%)	14 (35%)	28 (45.1%)
Vertical	9 (43%)	21 (52.5%)	25 (40.3%)
Unknown	-	5 (12.5%)	9 (14.6%)
Median time between diagnosis and treatment, yr (range)	2.8 (1-9)	2.5 (1-5)	Not determined
Response to treatment, n (%)
Sustained	6 (29%)	24 (60%)	36 (59%)
Transient	3 (14%)	1 (2.5%)	7 (11%)
No response	12 (57%)	15 (37.5%)	19 (30%)
Median ALT level ( U/L ) (range)
Before treatment	39 (13-386)	35.5 (7-90)	41.6 (11-293)
After treatment (24 mo)	35 (9-137)	22.1 (6-104)	23.1 (7-71)

Table 2 Positive¹ autoantibodies in the two treatment groups before, during and 12 mo after treatment

Group		Before treatment			During treatment			After treatment
	n	LKM2	SMA3	ANA4	LKM2	SMA3	ANA4	LKM2	SMA3	ANA4
IFN-monotherapy	21	1	0	0	2	0	2	1	1	2
IFN /ribavirin-combined treatment	18	0	0	2	0	2	1	0	0	0
Total	39	1	0	2	2	2	3	1	1	2

¹Antibody titer was considered positive at values ≥ 1:40;

²Liver kidney microsomal antibody;

³Anti-smooth muscle antibody;

⁴Antinuclear antibody.

Table 3 Thyroid function tests in the two treatment groups before, during and 12 mo after treatment

Group		Before treatment				During treatment				After treatment
	n	TGA1	TPOAb2	TSH3	FT34/FT45	TGA1	TPOAb2	TSH3	FT34/FT45	TGA1	TPOAb2	TSH3	FT34/FT45
IFN-mono-therapy	21	0	0	1	0	3	5	3	0	0	0	0	0
IFN/ribavirin-combined treatment	40	0	0	0	0	5	2	3	1	1	0	0	0
Peginterferon-α + ribavirin	62	ND	1	0	ND	ND	7	6	ND	ND	3	0	ND
Total	123	0	1	1	0	8	14	12	1	1	3	0	0

¹Thyroglobulin antibody (normal range < 50 U/L);

²Thyroid peroxidase antibody (normal range < 35 IU/mL);

³Thyroid-stimulating hormone (normal range 0.3-4.2 mU/L);

⁴Free triiodothyronine (normal range: 1.8-4.6 ng/L);

⁵Free thyroxine (normal range 7-19 ng/L). ND = not determined.

Table 4 Overview of the thyroid function and auto-antibody titers of the 12 children who developed pathologic values during the course of IFN-α treatment Median (range)

Treatment	TGA1	TPOAb2	TSH3	FT34	FT45
Before	29.0 (9.4-53.0)	3.2 (0-41.0)	2.7 (1.0-5.5)	3.15 (2.1-5.3)	1.2 (1.1-1.3)
During	100.0 (8.0-141.0)	82.5a (4-3 909)	7.3a (1.7-76.0)	2.12 (1.1-4.3)	1 (0.4-1.3)
After	40.0 (13-163.0)	4.5 (0-289.0)	2.2 (0.9-4.2)	4.0 (2.0-5.3)	1.1 (1.0-1.3)

^aP < 0.05 vs before and after treatment.

¹Thyroglobulin antibody (normal range < 50 U/L);

²Thyroid peroxidase antibody (normal range < 35 IU/mL);

³Thyroid-stimulating hormone (normal range 0.3-4.2 mU/L);

⁴Free triiodothyronine (normal range 1.8-4.6 ng/L);

⁵Free thyroxine (normal range 7-19 ng/L).