الفهرس 
Virology of Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
H
epatitis C virus (HCV) has emerged as a major worldwide public health problem. After the discovery of HCV as a major etiological agent of non-A non-B chronic hepatitis, it was found that this RNA virus was associated not only with chronic liver inflammation but also with an array of extrahepatic manifestations. One of which is the endocrinal manifestations including thyroid disorders, type II DM and gonadal disorders. AITD is a common finding in HCV positive patients. The presence of ATA prior to the start of combined Interferon and Ribavirin therapy necessitates close follow up for the thyroid functions during the course of the treatment.
The aim of this study was to determine the presence of ATA (anti-TG and anti-TPO) in HCV positive patients and their relation to the degree of severity of chronic liver disease assessed by (Child-Pugh classification). The secondary aim was to correlate between the levels of TSH and the presence of ATA.
The current study included eighty-four subjects divided into three groups. Group I included twenty-eight compensated HCV positive patients (Child A and early B) 14 males and 14 females with mean age 50.4±8.22 years, Group II twenty-eight decompensated HCV positive patients (late Child B and Child C) 12 males and 16 females with mean age 53.5± 5.6 years, lastly Group III included also twenty-eight normal healthy control subjects 13 males and 15 females with mean age 48.82±10.5 years.
Anti-TG and anti-TPO were done for all subjects revealing that high anti-TG was found in 27 out of 56 (48.2%) of all HCV positive patients of which 12 compensated and 15 decompensated. Anti-TPO levels were high in only 4 patients (7.1%) all were decompensated patients. None of our healthy control subjects showed anti-TG or anti-TPO positivity.
The results of the current study proved the positive link between ATA and HCV.
TSH levels were high in 19 out of 56 HCV patients (33.9%), only 6% of which were compensated HCV while 13% were decompensated. When free T3 and free T4 were investigated for those patients, it was found that 2 out of 6 had low T3 and 1 out of 6 was with low T4, while in decompensated HCV pt, 5 of them were found to have low T3 and only 2 with low T4. so not all patients with abnormal TSH were found to have abnormal free T3 and /or free T4.
TSH, anti-TG and anti-TPO being of higher values in decompensated HCV positive patients in the current study adds to the theory suggesting that AITD are directly proportional to the degree of fibrosis.
Normal levels of TSH cannot exclude the presence of ATA.