Thyroxine in the Treatment of Chronic Hepatitis C Infection: A Case Report

Introduction: Chronic hepatitis C is a common and potentially fatal hepatic infection worldwide with an expected increase in incidence of complications including hepatoma, cirrhosis, portal hypertension and potential death. Current treatment regimen includes combination interferon-alpha, ribavirin and recently direct acting antiviral agents. Treated patients who are exposed to high endogenous thyroid hormone concentrations, commonly due to interferon-induced thyroiditis, achieve a better sustained virologic response. It is therefore plausible that thyroxine can be a potential adjuvant therapy in this setting with favorable outcomes. Case Presentation: A 24 year-old woman with hypothyroidism and chronic hepatitis C, genotype 1, underwent routine treatment of interferon and ribavirin for 48 weeks. During the course of treatment and contrary to medical advice, she deliberately self-administered excessive thyroxine doses. Sustained virologic response was achieved at the completion of therapy despite her poor prognostic factors. Conclusion: This is the first case report of self-treatment with high doses of thyroxine during treatment with Interferon and Ribavirin, which results in a sustained virologic response, averting potential hepatic related complications. This observation potentially offers an additional adjuvant option in the treatment of chronic hepatitis C infection.