@article{AOT9266,
author = {Matthew G. Menkart and Jenna L. Oringher and Anjali Rai and Moumita Chakraborty and Gabriella M. Quinn and James A. Haddad and Kareen L. Akiva and Elizabeth C. Townsend and Rabab O. Ali and Christopher Koh and Regina Umarova and Elliot B. Levy and David E. Kleiner and Ohad Etzion and Rownock Afruza and Theo Heller},
title = {Changes in thyroid-stimulating hormone and thyroxine during hepatitis C virus infection and after direct-acting antiviral therapy independent of interferon exposure: a prospective paired cohort study},
journal = {Annals of Thyroid},
volume = {11},
number = {0},
year = {2026},
keywords = {},
abstract = {Thyroid dysfunction is a recognized extrahepatic manifestation of hepatitis C virus (HCV) infection, historically described in the context of interferon therapy or autoimmune thyroid disease. In the era of direct-acting antiviral (DAA) therapy, the clinical significance of subtle thyroid hormone alterations during untreated infection remains unclear, particularly given potential implications for routine screening, early detection of subclinical dysfunction, and long-term metabolic outcomes in the millions living with chronic HCV. This hypothesis-generating, observational analysis seeks to examine paired changes in thyroid function during HCV infection (HCVi) and after sustained virologic response (SVR) achieved with DAA therapy, independent of interferon exposure. Twenty-nine patients with chronic HCVi at the National Institutes of Health Clinical Center enrolled between 29 May 2015 and 11 March 2016, underwent sofosbuvir/velpatasivr therapy to achieve SVR. Twenty-four returned for post-SVR evaluation and five were excluded for levothyroxine use. Thyroid function, assessed via serum thyroid-stimulating hormone (TSH) using immunoassay and relative thyroxine (T4) levels via non-targeted metabolomics, was measured during infection and approximately 1 year after SVR. Paired analyses were performed in patients with measurements at both time points. Patients were stratified as cirrhotic (C) or non-cirrhotic (NC), classified based on Ishak Fibrosis (IF) score from percutaneous liver biopsy. Among 24 patients with follow-up, 15 had paired TSH measurements (median age 59, 66.7% male, 42.1% C). During HCVi, TSH was significantly lower (median 2.01 vs. 2.27 mIU/L, P},
issn = {2522-6681}, url = {https://aot.amegroups.org/article/view/9266}
}