STUDY OF RELATION OF HEPATITIS C SEROPOSITIVITY TAND THYROID DISEASES IN PREVALENT HEMODIALYSIS PATIENTS

INTRODUCTION AND AIMS: Thyroid disorders are not uncommon in in prevalent hemodialysis patients (HD). Hepatitis c virus infection with normal kidney functions , is also commonly associated with thyroid disorders. Though hepatitis C virus infection in HD patients is still a common problem , we detected no previous attempts in the literature to assess the possible effect of hepatitis C infection on thyroid disorders in HD patients. . METHODS: Twenty hepatitis C seropositive prevalent HD patients (group A) , another twenty hepatitis C seronegative prevalent HD patients (group B) were randomly selected from our HD unit. A third group ( group C) of thirty apparently healthy subjects was also randomly selected . The three groups were similar in age ,sex , and BMI and duration of HD. Exclusion criteria included unstable patients , those with known thyroid diseases , those taking drugs that may affect thyroid functions or suffering from systemic diseases that may affect thyroid functions . All three groups were studied by detailed history and clinical examination , CBC and routine chemistry liver enzymes and liver function tests , in addition to free T3, free T4,TSH, reverse T3 and thyroid (TUS) and abdominal ultrasound . RESULTS: We detected sick thyroid syndrome( low free T3 /normal TSH ) in 15 cases (75%) of group A (seropositive) compared to 12 cases( 60%) of group B (seronegative) but without statistical significance. Increased reverse T3 was detected in 7 cases (35%) in each group. Only one case in group B showed subclinical hypothyroidism while the rest of cases in both groups were showed normal thyroid function tests . TUS showed enlarged thyroid in one case , nodules in ten cases of seropositive group (A) while enlarged thyroid in two cases , nodules in ten cases of seronegative (group B) with no significant differences between the two groups . Moreover, neither liver enzymes nor liver function tests correlated significantly with free T3 ,free T4, TSH, reverse T3, nor thyroid US findings in either of the studied HD groups (A&B) . CONCLUSIONS: It may be concluded that hepatitis C seropositive prevalent HD patients are not vulnerable to increased frequency nor severity of thyroid disorders compared to seronegative HD patients.