Hepatology International

, Volume 12, Issue 2, pp 143–148 | Cite as

High prevalence of HCV (GT4)-related TSH abnormality among 13402 Egyptian patients treated with direct acting antiviral therapy

  • Rasha Eletreby
  • Mohamed Said
  • Zeinab Abdellatif
  • Yasmin Saad
  • Magdy ElSerafy
  • Hosam Dabes
  • Kadry ElSaeed
  • Yehia El-Shazly
  • Wahid Doss
Original Article



HCV is associated with several extra hepatic diseases including thyroid dysfunction. This study aims at evaluating prevalence of thyroid dysfunction and its possible predictors in a large cohort of HCV GT4-infected patients, and the role of thyroid dysfunction as a predictor of response in the setting of direct acting antivirals (DAAs).


Patients registered on the web-based registry system to receive therapy for chronic HCV in Beheira governorate viral hepatitis specialized treatment center affiliated to the National committee for control of viral hepatitis (NCCVH), Ministry of health, Egypt in the period from January 2015 to October 2016. Their data were exported and analyzed for the prevalence of thyroid dysfunction and its associated variables.


Out of 13,402 patients, 2833 (21.1%) had elevated TSH level > 4.5 mIU/l (hypothyroidism). Female gender (62.7%), older age, higher FIB4, AST, and BMI and lower albumin were significantly associated with elevated TSH level on univariate analysis, while liver stiffness measured by fibroscan was not significantly associated. On the other hand, 466 patients (3.5%) showed low TSH level < 0.4 mIU/l (hyperthyroidism). Older age (median 52 years) and male gender (51.5%) were the only significantly associated variables. No association was found between SVR and baseline TSH level. Follow-up of 236 patients after SVR revealed improvement in TSH level in 80% of them.


Hypothyroidism is prevalent in patients with chronic HCV GT4, and is influenced by patient gender and age. Pretreatment TSH does not affect SVR after DAAs. Despite limited data SVR achievement after DAAs improves thyroid dysfunction.


Genotype IV HCV Thyroid dysfunction 



No funding source to be acknowledged.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Asian Pacific Association for the Study of the Liver 2018

Authors and Affiliations

  • Rasha Eletreby
    • 1
  • Mohamed Said
    • 1
  • Zeinab Abdellatif
    • 1
  • Yasmin Saad
    • 1
  • Magdy ElSerafy
    • 1
  • Hosam Dabes
    • 2
  • Kadry ElSaeed
    • 3
  • Yehia El-Shazly
    • 3
  • Wahid Doss
    • 1
  1. 1.Hepatology and Endemic Medicine DepartmentCairo UniversityCairoEgypt
  2. 2.Medical National InstituteDamnhourEgypt
  3. 3.Internal Medicine DepartmentAin Shams UniversityCairoEgypt

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