Sub-Clinical Thyroid Disorders in Patients With Hepatitis C Before and After Conventional Treatment
Bibliographic record
Abstract
Objective: Thyroid dysfunction represents one of the commonest endocrine manifestations of chronic hepatitis C infection, exaggerated by interferon based treatment.The purpose of this study was to assess the frequency of hepatitis C virus and sub-clinical thyroid disorder in patients with hepatitis C before and after treatment.Methods: This is an observational, cross sectional analysis conducted in Lyari general hospital and Abbasi Shaheed hospital from January 2009 to December 2015.Patients with a positive rt-PCR and genotype 3 were included in the study.After a positive rt-PCR, patients were screened by thyroid stimulating hormone before starting the treatment.All patients were given therapy of conventional interferons (3 million units thrice weekly) and ribavirin (800 mg per day in two divided doses) for a period of 6 months.Patient with normal TSH level was included and patients with a co-existing hepatitis B or D were excluded from the study.After 6 months of therapy all patients had a repeat rt-PCR to see the end treatment response to therapy and a thyroid stimulating hormone to screen for thyroid disorders.Results: A total of 129,430 patients have visited the medical outpatient department of which, 4069 were HCV RNA PCR positive.The prevalence of unrecognized hepatitis C Virus was 13.4% in the study population.The prevalence of sub-clinical thyroid disorders was 9%.Of which 6.5% had sub-clinical hypothyroidism and 2.5% had overt or subclinical hyperthyroidism.A total of 2196 patients were included in the analysis.Mean age was 36.22 ±10.01 years range from 16 to 63 years.Among all 36.9% were male and 5.1% were known diabetics.On the whole 14.8% were non-responders, 80.9% achieved an end treatment response and 4.3% lost to follow up.We observed an association between the post treatment TSH level and the ETR of HCV (p=0.015).A statistically significant difference (p<0.001;95% CI -3.008-1.577)was observed in the thyroid stimulating hormone at the baseline and following the conventional interferon and ribavirin therapy for a period of 6 months.388 (17.6%) patients had abnormal thyroid function tests after conventional interferon treatment.These 388 patients were further followed up for 6 months. Conclusion:In conclusion, this study results shows 13.4% prevalence of HCV in Karachi and the prevalence of sub-clinical thyroid disorders was 9%, of which 6.5% and 2.5% had overt hypothyroidism and hyperthyroidism respectively.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".