Of the 23.4% (26/111) of patients whose thryoid dysfunction never normalised, 42% (11/26) had significant disease. The most common pattern of significant thyroid dysfunction was isolated hyperthyroidism, followed by a combination of both hyperthyroidism and hypothyroidism in the same patient at different points in time. Treatment of the dysfunction varied between watchful waiting and thyroid replacement or suppression with thyroxine or carmbimazole respectively. A Chi Squared test of independence showed no associated Kinase Inhibitor Library cell assay between thyroid
disease and autoantibodies (p = 1.00); or SVR (p = 0.980). Female gender was predictive of thyroid dysfunction (OR: 2.7 p = 0.0001, 95%CI 1.6–4.5). Thyroid disease was also more likely to occur in patients with genotype 1 (OR 2.25, p = 0.014 95%CI 1.35–3.76) perhaps due to longer treatment duration. Conclusion: Those patients with pre existing thyroid disease were more likely to develop thyroid dysfunction
during antiviral therapy, even if clinically insignificant disease existed pre-treatment. Females, and patients with genotype 1 were also more likely to develop thyroid dysfunction. Ongoing thyroid dysfunction after treatment occurs not infrequency, and ongoing monitoring is warranted. The incidence of thryoid disease during HCV treatment with interferon is relatively high, and clinicians should ensure appropriate screening and treatment, if this complication occurs. E SHELTON,1 C PEI CHONG,2 L SHOCHET,2 J CHEONG,2. S ONG,1 D BOWDEN,2 A HODGE,1 V KNIGHT,1 K CHENG,3 S PASRICHA*,2 A DEV*1 1Department of Gastroenterology CH5424802 and Hepatology, 2Medical therapy unit (Thalassaemia Service) and 3Radiology, Monash Health, Melbourne, Australia. Background: Transfused haemoglobinopathy (TH) patients
are at significant risk of liver cirrhosis and its sequelae due to hepatic iron loading and transfusion related hepatitis C (HCV).(1) Screening for liver fibrosis in this population is inadequate using current methods – pathology, liver ultrasound and T2*MRI. Transient elastography (TE) non-invasively assesses liver stiffness and hence, risk of cirrhosis and has been 上海皓元医药股份有限公司 validated in many clinical scenarios including viral hepatitis. It has been studied in small cohorts of patients with beta thalassemia.(2,3) The present study aimed to evaluate the prevalence of cirrhosis in a cohort of adult TH patients using TE. Methods: 128 TH patients were identified by enrolment at the State Thalassaemia reference centre between August – November 2012. Of these, 63 patients (males 46%, B thalassemia major 95%, HCV Ab positive 54%) prospectively underwent TE. Liver ultrasound, T2*MRI and present and historical ferritin, data were collected. Associations between risk factors and loge TE were compared by linear regression, and associations between TE thresholds (>7.9 kPa for F ≥ 2, >10.3 for F≥3, >11.9 for F = 4) versus normal, by logistic regression.