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Domest Anim Endocrinol 2015

Yes, hybrid protocols using IM loading doses followed by SubQ maintenance are viable and sometimes advantageous when rapid initial saturation is needed but long-term sustained levels matter more

Future directions Several critical areas need further investigation to fully comprehend the complex relationship between the microbiome, TMAO, and cardiovascular disease

Thyroid Disease Thyroid disease occurs in an estimated 2 to 13% of persons with chronic HCV.[38,39] In a study of 630 participants with chronic HCV and no cirrhosis, investigators found that 17% had anti-thyroglobulin antibodies, and 21% had antithyroid peroxidase antibodies.[38] Among patients with HCV in this study, the prevalence of hypothyroidism was 13%, and serum thyroid stimulating hormone (TSH) levels were significantly higher in those with chronic HCV when compared to control arms from both iodine-deficient and iodine-sufficient areas.[38] Sjgren's Syndrome Several studies suggest an association between HCV infection and Sjgren's syndrome.[40,41] In a meta-analysis evaluating the frequency of extrahepatic manifestations of HCV, authors found that the pooled prevalence of Sjgren's syndrome across 11 studies was 11.9% among HCV-positive individuals, in comparison to 0.7% among HCV-negative controls.[6] Similarly, in a multicenter registry of patients with chronic HCV and systemic autoimmune diseases, Sjgren's syndrome was the most frequently reported (47.5%) systemic autoimmune disease (47.5%).[34] Renal Disorders Renal Manifestations Associated with HCV Infection A subset of renal glomerular diseases are strongly associated with HCV infection.[42,43] In addition, individuals with chronic HCV can develop albuminuria without overt renal disease, particularly persons 60 years of age or older.[44,45] The evidence for HCV infection causing renal disease is mainly supported by epidemiologic data.[6,46,47,48,49] When HCV-related glomerulonephritis develops, it typically occurs many years, often decades, after initial infection with HCV