Can pegylated interferon α 2a cause development of thyroid disorders in patients with chronic hepatitis B?

Expert Opin Drug Saf. 2014 Aug;13(8):1009-14. doi: 10.1517/14740338.2014.921156. Epub 2014 Jun 14.

Abstract

Introduction: Hepatitis B virus infection is treated with pegylated (Peg) IFNα and nucleos(t)ide analogues. The disadvantages of PegIFNα include thyroid disorders. In this single-center study, the type, incidence and consequences of thyroid dysfunction in patients receiving PegIFNα due to chronic hepatitis B (CHB) were analyzed.

Patients and methods: The analysis included 106 patients (80 males) with CHB, aged 20 - 58 years, treated with PegIFNα-2a at a dose of 180 μg/week subcutaneously for 48 weeks. The levels of thyroid-stimulating hormone (TSH) and thyroid antibodies (TAbs) that is anti-thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies were measured in all patients at baseline. Furthermore, TSH was measured every 3 months during treatment and for 12 months after completion of treatment. If the TSH level was abnormal, free thyroxine 4 levels and TAbs were measured.

Results: All patients started the therapy with normal TSH and TAb levels. In 99 patients, TSH levels remained normal throughout the therapy. Thyroid disorder occurred in seven patients (6.6%), six of whom developed hypothyroidism and one who developed hyperthyroidism. Thyroid dysfunction was diagnosed in six women and one man. TAbs (only TPOAbs) were found in two patients (1.88%).

Conclusions: Thyroid disorder is a rare, though possible not transient, complication of IFN therapy in CHB patients.

Keywords: anti-thyroid peroxidase antibodies; chronic hepatitis B; pegylated IFN α; thyroid diseases.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Female
  • Hepatitis B, Chronic / drug therapy
  • Humans
  • Hyperthyroidism / chemically induced*
  • Hyperthyroidism / epidemiology
  • Hypothyroidism / chemically induced*
  • Hypothyroidism / epidemiology
  • Incidence
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Iodide Peroxidase / immunology
  • Male
  • Middle Aged
  • Polyethylene Glycols / adverse effects*
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Thyrotropin / metabolism
  • Young Adult

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Thyrotropin
  • Iodide Peroxidase
  • peginterferon alfa-2a