Risk factors for retinopathy associated with interferon alpha-2b and ribavirin combination therapy in patients with chronic hepatitis C.
OBJECTIVE
To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy.


METHODS
We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy.


RESULTS
Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR = 245.918, 95% CI = 5.6-10786.2).


CONCLUSIONS
Retinopathy associated with combination therapy of interferon alpha-2b and ribavirin tends to develop in patients with hypertension.
Okuse
Chiaki
C
Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Yotsuyanagi
Hiroshi
H
Nagase
Yoshihiko
Y
Kobayashi
Yuhtaro
Y
Yasuda
Kiyomi
K
Koike
Kazuhiko
K
Iino
Shiro
S
Suzuki
Michihiro
M
Itoh
Fumio
F
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005654:Fundus Oculi; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011994:Recombinant Proteins; D012044:Regression Analysis; D012164:Retinal Diseases / Q000139:chemically induced*; D012166:Retinal Hemorrhage / Q000139:chemically induced / Q000209:etiology; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use*; D012307:Risk Factors; D013997:Time Factors
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin