Fatal cardiomyopathy associated with pegylated interferon/ribavirin in a patient with chronic hepatitis C.
We report the case of a 45-year-old man with HCV treated with pegylated interferon-alpha/ribavirin, in whom fatal cardiomyopathy occurred. Cardiomyopathy is a rare complication of high dose of standard interferon but has never been reported with pegylated interferon. The relationship between pegylated interferon-alpha/ribavirin and the development of cardiomyopathy is highly probable for the following reasons: (1) a cardiologist consultation with specific investigations had been performed before treatment excluding a pre-existing cardiomyopathy; (2) symptoms of advanced dilated cardiomyopathy appeared immediately after the end of treatment; (3) other causes of cardiomyopathy have been ruled out. In all except one of the 21 reported cases with standard interferon, cardiomyopathy was reversible. In our patient, fatal cardiomyopathy occurred with a usual dose of pegylated interferon-alpha. Clinicians should be aware of this potential complication when evaluating the ratio benefit/risk of treatment in patients with chronic hepatitis C infection.
Condat
Bertrand
B
Service d'hépato-gastroentérologie, Hôpital Saint-Camille, Bry sur Marne, France. B.Condat@ch-bry.org
Asselah
Tarik
T
Zanditenas
David
D
Estampes
Bertrande
B
Cohen
Ariel
A
O'Toole
Dermot
D
Bonnet
Joëlle
J
Ngo
Yann
Y
Marcellin
Patrick
P
Blazquez
Martine
M
D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a