| Objectives:Discuss the correlation between thyroid dysfunction(TD)and chronic hepatitis C(CHC),To observe the efficacy evaluation of DAAs in CHC patients with TD,and the effect of DAAs on thyroid function during antiviral therapy.Methods:Randomly selecting 138 patients with chronic hepatitis C who received treatment in the First People’s Hospital of Yunnan Province from September 2020 to October 2022.According their serum hepatitis C virus-ribonucleic acid(HCV-RNA)levels,there were 49 cases in the low expression group(HCV-RNA<105 IU/mL),55 cases in the high expression group(HCV-RNA>105 IU/mL),and 60 healthy subjects who came to our hospital during the same period were randomly selected as the control group.Relevant laboratory indicators,including thyroid function and biochemical indicators,were collected to explore the relationship between thyroid function and the biochemical indicators and HCV-RNA load in patients with CHC.According to whether they had thyroid dysfunction or not,they were divided into hepatitis C group and hepatitis C combined with thyroid dysfunction group.22 cases of hepatitis C combined with TD and 27 cases of hepatitis C were selected,and 27 cases of healthy person who came to our hospital during the same period were randomly selected as the control group.The laboratory indicators of the three groups were analyzed statistically.10 CHC patients with TD were randomly selected to follow up the effect of direct-acting antivirals(DAAs)treatment,and the changes of thyroid function,biochemistry and blood routine before and after treatment.Results:Among 138 patients with CHC,there were 22 patients with TD,the detection rate was 15.94%.Among control group,low HCV-RNA group and the high HCV-RNA group,ALT,AST,GLB,ALB,DBIL,TG,T4,T3,FT4 and FT3 were statistically significant differences(P<0.05).A multivariate unordered logistic regression analysis of indicators that were included in the univariate analysis of significance showed that compared with the control group,GLB(OR=1.202,95%CI=1.004-1.439,P<0.05)in the low expression group was a possible predictor of increased viral load in patients with hepatitis C.Compared with the control group,GLB(OR=1.230,95%CI=1.025-1.475,P<0.05)in the high expression group might be the predictor of increased viral load.AST(OR=1.034,95%CI=1.008-1.060,P<0.05)may be the predictor of high expression group compared with low expression group.There were statistically significant differences in ALT,AST,DBIL,ALP,ALB,TG,GLB,TSH,T3,FT4 and FT3 among control group,hepatitis C group and hepatitis C combined with TD group(P<0.05).The early virological response(EVR)rates and sustained virologic response(SVR)rates of 10 patients with CHC and TD after DAAs treatment were 100%.The differences in TSH,T4,T3,FT4 and FT3 before and after treatment with DAAs were not statistically significant(P>0.05);however,five patients with subclinical thyroid dysfunction returned to normal after DAAs treatment.AST,AFP and ALT were significantly lower than baseline in patients with CHC combined with TD at 12 weeks of treatment and at 12 weeks of discontinuation(P<0.05);TBIL,DBIL and GGT were significantly lower than baseline at 12 weeks of discontinuation(P<0.05).Conclusions:1.There was high prevalence of thyroid dysfunction in CHC patients.2.Thyroid hormone levels in CHC patients are related to the level of viral load.GLB and AST may be predictive factors of increased viral load in patients with hepatitis C.The results initially suggest that some subclinical thyroid dysfunction in CHC patients with combined TD treated with DAAs may improve after obtaining remission of HCV infection through DAAs. |
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