[The treatment of HCV infection with interferon alpha and ribavirin in a child with diabetes I type].
HCV is a leading cause of chronic hepatitis in worldwide and diabetes is thought to be a risk factor of HCV infection. Interferon treatment may induce the autoimmune reactions. We report a case of 10 year old girl with diabetes since 4 th year of life and HCV infection since 9 year of life, treated with alpha-interferon and ribavirin for 12 months. Interferon was administered in doses of 3 MU 3 times a week, ribavirin 200 mg 3 times daily. Liver function (ALT, AST, GGT, prothrombin) and morphology was monitored every 6 weeks. Autoantibodies (ANA, ASMA, AMA, ATG, TPO) were tested before the treatment, after 6 and 12 months of the treatment. We have observed the adverse reactions typical for interferon and ribavirin treatment, such as: loss of appetite, muscle and joint pains, hair loss, emotional lability, concentration disturbance, irritability, somnolence and mental depression, which subsided after the end of the treatment. The transitional ALT, AST elevation in 6th month of the treatment was observed. During the therapy hypothyreosis was diagnosed in the 7th month, and thyroid autoantibodies (ATG and TPO) appeared in the 12th month. ANA antibodies were present before therapy and its titer increased after 6 month of treatment. During the therapy pneumonia, thrombocytopaenia and anaemia were observed in 6th month.


CONCLUSIONS
diabetes is not contraindication to interferon and ribavirin treatment. Interferon treatment in the patients with genetic predisposition to thyroid gland diseases and in the patients with present autoantibodies ought to be applied with special caution.
Jasonek
Jolanta
J
Katedra i Klinika Chorób Zakaźnych Dzieci Akademia Medyczna we Wrocławiu.
Kacprzak-Bergman
Irma
I
Zaleska
Izabela
I
D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000998:Antiviral Agents; D004338:Drug Combinations; D016898:Interferon-alpha; C118689:Rebetron; D012254:Ribavirin