Thyroid disturbances in children treated with combined pegylated interferon-alpha and ribavirin for chronic hepatitis C

Background: Immunomodulatory properties of interferon (IFN) have been documented. It may induce autoimmune diseases such as autoimmune thyroiditis with hypo- or hyperthyroidism. In addition, it may impair thyroid hormone synthesis through affecting iodide organification in thyroid gland. Purpose: The aim of this study was to describe thyroid function tests disturbances in children with chronic hepatitis C (CHC) receiving pegylated interferon-alpha (PEG IFN-alpha) plus ribavirin. Methods: Fifty children with CHC virus infection who receiv-ed combined pegylated interferon-alpha with ribavirin were selected. Other 50 apparently healthy children of matched age and sex (considered as control group) were selected. All children (100) were subject to liver function tests, virological studies, and follow-up of thyroid function test during and after the treatment course. Results: Our study showed that 28% of children received combined PEG IFN-alpha plus ribavirin showed subclinical hypothyroidism. After 24 weeks treatment with combined therapy of IFN plus ribavirin, the mean level of thyroid stimulating hormone (TSH) was 3.23 +/- 88 mU/mL, while TSH was 1.16 +/- 0.77 mU/mL before starting treatment. On the other hand, mean TSH was 1.09 +/- 0.92 mU/mL in normal control group. Conclusion: This study revealed an association between subclinical thyroid dysfunction and treatment with IFN-alpha and ribavirin in children. Further studies on larger number of patients and longer follow-up duration are recommended for further confirmation.