Abstract

Introduction: Interferon alfa is preferred in treatment of hepatitis B, especially for young patients, because of the greater chance of HBs Ag loss, the absence of resistance and the finite duration of treatment. But its side effects like flu like symptoms, asthenia, neuropathy, anxiety, depression, hepatotoxicity, neutropenia, thrombositopenia and throid disfunction causes poor tolerance to treatment. We described a chronic hepatitis B patient who had thyroid dysfunction during Peg-IFNα therapy. Case: A twenty-nine year old woman admitted to hospital with hair and weight loss on fourth month of Peg-IFNα therapy while her TSH level was normal at the beginning of the treatment. AST and ALT levels were within normal limits and HBV DNA was negative, TSH was low and T3 and T4 levels were high. Anti thyroid peroxidase antibody, anti thyroglobulin antibody and TSH receptor antibody were positive. Tiroid US and radioactive iodine uptake tests were compatible with troiditis. Peg-INFα was continued and the patient was not treated for hyperthyroidism. At the eight month of Peg-INFα therapy, levothyroxine was initiated for subclinical hypothyroidism. Hepatitis B treatment ended in the 48th week. Thyroid functions were normal at the end of HBV treatment and follow-up. At the fourth year of the therapy the patient had HBs Ag seroconvertion, with Anti HBs level of 250mU/mL. Conclusion: The patients who have Peg-IFNα treatment should be evaluated for thyroid dysfunction and probability of thyroiditis should be kept in mind. As optimal treatment duration is important for achievement of Hbs Ag seroconvertion, appropriate management of side effects is essential in these patients.