FREQUENCY OF THYROID-DYSFUNCTION AFTER RECOMBINANT ALPHA-INTERFERON THERAPY IN GREEK PATIENTS WITH CHRONIC ACTIVE HEPATITIS

Objective: To determine the frequency of organ and non-organ specific autoantibodies, autoimmune diseases, in particular thyroid dysfunction, as well as their influence on therapeutic results during alpha-interferon (alpha-INF) therapy in Greek patients with chronic viral hepatitis. Patients: The study included 32 patients (18 men and 14 women; aged 24-68 years) with clinically, biochemically, serologically and histologically proven chronic active hepatitis. Interventions: Recombinant alpha-2b-INF (5 x 10(6) units subcutaneously) three times weekly for 6 months. Main outcome measures: Signs and symptoms of autoimmune disease, including thyroid dysfunction, or development of autoantibodies to thyroid and nuclear antigens. The response to therapy was determined by reduced transaminase levels. Results: Antimitochondrial, smooth muscle and antithyroid antibodies were not detected either before, or after the end of therapy. Antinuclear antibodies (ANA) were detected in 15 patients [46.9%; 95% confidence interval (CI) 29.1-65.3%] before therapy (six of whom had an increased titre after therapy) and in another six (previously ANA-negative patients) after alpha-INF therapy (59.4%; 95% CI 40.6-76.3%). Two patients (6.25%; 95% CI 0.77-20.8%) developed thyroid dysfunction (hyperthyroidism) and returned to the euthyroid state 2 months after suspension of alpha-INF therapy (one without antithyroid drugs). The response to therapy was not associated with the presence and/or induction of ANA. Conclusions: At least in our area, the presence of ANA or their slight induction following therapy with alpha-INF is not a contraindication to the use of this therapy in patients with chronic viral hepatitis. Thyroid dysfunction was observed at a lower frequency than that found in northern European countries, whilst autoimmune diseases, other than thyroid dysfunction, were not observed. The aetiological relationship, however, between thyroid dysfunction and alpha-INF therapy in the context of an autoimmune response could not be determined in this study, as none of the patients developed antithyroid antibodies.