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A complex relationship exists between the thyroid gland and the liver in both health and disease (Malik et al., 2002).
The direct link between HCV infection and thyroid diseases is unclear, but thyroid disorders (usually hypo-thyroidism) is more commonly seen in people with HCV than in the general population (Huang et al., 1999). The presence of thyroid antibodies is usually a pre-clinical phase of autoimmune thyroid disorders (AITD) (Vanderpump et al., 1995).
Concerning hepatitis B virus infection, few available studies assessed the relation between chronic HBV infection and thyroid gland affection.
To fullfil the aim of the work, this study was designed to assess the frequency of thyroid dysfunction, as well as to evaluate the value of antithroglobulin and thyro-proxidase antibodies in early diagnosis of subclinical hypothyroidism, in Egyptian patients with chronic viral hepatitis (B and C).
This study was conducted in co-operation between Tropical Medicine Department and Endocrinology Department, Ain-Shams University. It included patients who were attending the out-patient clinic of Tropical Medicine Department, Ain-Shams University Hospital and Yassin Abdel-Ghaffar charity Center for Liver Diseases and Research from August 2012 and September 2013.
The study was performed on 80 patients (divided equally) with proven chronic hepatitis C or B virus infection according to the pre-designed inclusion criteria. As well as, a Control group included forty aged and sex matched healthy subjects.
All patients were subjected to the following; careful history, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood picture, viral markers (HCV-Ab, HBs-Ag and quantitative PCR for HCV-RNA and\or HBV if available), alfa fetoprotein and abdominal ultrasound. As well as, TSH, thyroglobulin Ab and thyroperoxidase Ab were done for all the studied patients and control.
The clinical presentations of the studied group; easy fatiguability, right hypochondrial pain and hepatomegaly were the most frequent clinical presentation in HCV group, followed by HBV group and absent in control group, the differences were statistically significant.
The current study reveals that HCV group had slightly elevated serum TSH than those with HBV infection and than Controls but without statistical significant difference. There were significantly higher levels of Antithyroglobulin and Thyroperoxidase Abs in HCV group than HBV group and the control group, Also, subclinical hypothyroidism was significantly present in HCV group more than HBV & control group
A Comparison study between euthyroid and subclinical hypothyroidism in HCV group was done in the current study. Females were significantly more frequently affected by subclinical hypothyroidism in HCV group (12 female patients (85.7%)) within age 49.9±11.0
Antithyroglobulin and Thyroperoxidase were significantly higher among subclinical hypothyroidism than euthyroid in HCV group.
Peformance of the studied laboratory findings in prediction of subclinical hypothyroidism in HCV group, revealed that Antithyroglobulin and Thyroperoxidase were excellent predictors for subclinical hypothyroidism in HCV group.
The current study assessed the diagnostic characteristics of Antithyroglobulin ≥35.0 and Thyroperoxidase ≥35.0 in prediction of subclinical hypothyroidism in HCV group, Antithyroglobulin ≥35.0 was an optimum test, while Thyroperoxidase ≥35.0 was a perfect test in prediction of subclinical hypothyroidism in HCV group.
Anti thyroid antibodies (Thyroperoxidase Ab and Thyroglobulin Ab) provide valuable information regarding the thyroid dysfunction that may occur in patients with hepatitis C and B virus.
Therefore, the association between thyroid autoantibodies and HCV infection is of considerable clinical significance