Side effects of high-dose interferon therapy for chronic hepatitis C.
OBJECTIVE
Various side effects have been reported in patients treated with alpha interferon, but their incidence and prognosis remain unknown.


METHODS
Nine hundred and eighty-seven patients with chronic active hepatitis C received 6 to 10 MU of alpha interferon per day for 2 weeks and 3 times per week for 22 weeks. Autoantibodies, thyroid function tests, and fasting plasma glucose concentrations were evaluated prior to alpha interferon therapy.


RESULTS
Of the 987 patients, 310 were required reduction in the dose of alpha interferon to 3 MU/day or cessation of alpha interferon therapy because of adverse reactions such as flu-like symptoms, leukopenia, and thrombocytopenia. Of the remaining 677, five developed diabetes mellitus, 12 had hyperthyroidism, and six acquired hypothyroidism. Of the 18 with thyroid disorders, five demonstrated antimicrosomal antibodies before therapy. Forty-four patients revealed high or low concentrations of thyroid stimulating hormone at the end of alpha interferon therapy. Three patients developed interstitial pneumonia, one acquired systemic lupus erythematosus-like syndrome, two had autoimmune hepatitis, two developed rheumatoid arthritis, and one developed autoimmune thrombocytopenic purpura. No patients had a history of an autoimmune disorder. One patient experienced sudden hearing impairment and one had retinal detachment. Melena was seen in three patients; two of these cases were compatible with ischemic colitis. Symptoms of depression were seen in 23 patients, and one patient manifested memory loss.


CONCLUSIONS
High-dose alpha interferon therapy induces various adverse effects. Most of the side effects cannot be predicted, but are reversible.
Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Japan.
T
T
Okanoue
S
S
Sakamoto
Y
Y
Itoh
M
M
Minami
K
K
Yasui
M
M
Sakamoto
K
K
Nishioji
T
T
Katagishi
Y
Y
Nakagawa
H
H
Tada
Y
Y
Sawa
M
M
Mizuno
K
K
Kagawa
K
K
Kashima
D000328:Adult; D001327:Autoimmune Diseases / Q000209:etiology; D002908:Chronic Disease; D004700:Endocrine System Diseases / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D007372:Interferons; D017563:Lung Diseases, Interstitial / Q000209:etiology; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D012164:Retinal Diseases / Q000209:etiology; D013959:Thyroid Diseases / Q000209:etiology
D016898:Interferon-alpha; D007372:Interferons