Follow-up of patients with chronic hepatitis C who discontinued antiviral treatment because of side effects
W. Kryczka, D. Zarębska-Michaluk, K. Paluch
Med Sci Monit 2003; 9(2): 10-
Background:Premature withdrawal from antiviral therapy due to adverse events was required in 10%to 14%of chronic hepatitis C (CHC)patients (Fried MW:Hepatology 2002;36: S237-S244).There is a few data about subsequent history of them.The aim of our study was to evaluate the outcome of HCV infection among patients for whom the antiviral therapy had been withdrawn due to severe adverse effects. Material/Methods: Of the all 196 CHC patients treated with interferon alpha (alone or with ribavirin),26 (F/M:17/9;age: 23 –66,median:43.5yrs)had required cessation of therapy (3 to 34,median 16 weeks)because of adverse reactions.There were:angina pectoris (5),autoimmune hepatitis (1), tuberculosis (1),pyonephrosis (1),thrombocytopenia (3), ketoacidotic diabetes (1),thyrotoxicosis (10),manic psychosis (3)and retinal detachment (1).All patients were followed up to 12 –60 (median 24)months after cessation of therapy (CT).Results:In all patients,the adverse effects had been withdrawn during follow-up after CT.At the moment of CT,10 patients showed complete (biochemical and virological)response but only 4 of them maintained sustained response (SR)up to end of follow-up.Of 16 non-responders at CT,3 patients spontaneously cleared HCV and normalised ALT during follow-up.Those 7 patients with SR (4F/3M)were younger and had been treated longer than the others.Conclusions:About a quarter of patients with CHC who discontinued antiviral treatment because of side effects eliminated HCV either at CT or during follow-up.