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Combination treatment with pegylated interferon and ribavirin has been established as a standard therapy for chronic hepatitis C. Although interferon therapy is relatively safe, an important side effect is the induction of autoantibodies and autoimmune disease, especially autoimmune thyroid disease. Interferon associated autoimmune thyroid disease can consist of autoimmune hypothyroidism, Graves' disease, and destructive thyroiditis. Thyroid disease may lead to dose reduction or discontinuation of therapy.