Endocrine Abstracts

In Ukraine, in 2017, an estimated 53000 people were living with chronic hepatitis C virus (HCV) infection, and its prevalence rate was 123.7 patients per 100000 citizens. Symptoms of at least one extra hepatic manifestations appear in more than 50% of HCV-positive patients, and thyroid abnormalities are rather common. The purpose of the study was to determine the prevalence of thyroid function tests and anti-thyroid autoantibodies abnormalities in the untreated patients with chronic HCV infection. This retrospective study included 58 HCV (RNA+) patients, 18 males (31.0%) and 40 females (69.0%), and 23 apparently healthy controls. The mean age of patients was 40.4 ± 5.9 years. Routine clinical assessment and tests, and thyroid gland sonography were performed at the baseline. Thyroid function tests, including serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and antibodies to thyroid peroxidase (TPO) were performed by an ultrasensitive immune chemiluminescent noncompetitive assay. Ultrasound thyroid abnormalities included heterogenous parenchyma in 14 (24.1%) and grade 1 goiter in 16 (27.6%) cases. TPO were three times higher in HCV patients, 26.06 ± 1.23 IU/ml as compared to 8.69 ± 0.87 IU/ml in control. The mean TSH levels were significantly higher in HCV patients versus control, 3.78 ± 0.41 uIU/ml and 2.08 ± 0.54 uIU/ml respectively. FT4 and FT3 levels were not changed significantly. Mean FT4 concentration in HCV patients versus control was 1.18 ± 0.05 and 1.25 ± 0.08 ng/dl, and mean FT3 level – 4.95 ± 0.51 and 5.28 ± 0.47 pmol/l respectively. Increasing of TPO levels over upper normal limit was found in 15 (25.9%) cases, 11 (27.5%) females and 4 (22.2%) males. In 5 (12.5%) females observed clinically significant TSH rising. In 4 (10.0%) of them increased TSH was accompanied by high TPO and specific ultrasound abnormalities, thus autoimmune thyroiditis with hypothyroidism was diagnosed. In 1(2.5%) female patient subclinical hypothyroidism was diagnosed due to isolated TSH increasing in the subclinical range of hypothyroidism, and absence of clinical signs. Therefore, increasing of TPO levels was detected in more than 25%, and hypothyroidism was diagnosed in 12.5% untreated patients with HCV infection; HCV-associated thyroid dysfunction was specific for females.