title: Falsely low hemoglobin A1c levels in a patient receiving ribavirin and peginterferon alfa-2b for hepatitis C.
abstract: The effect of treatment for hepatitis C viral infection on hemoglobin A(1c) (A1C) levels is not well described in the literature. We describe a 59-year-old man with type 2 diabetes mellitus whose A1C level became falsely low when ribavirin and peginterferon alfa-2b therapy were started for treatment of hepatitis C. After treatment was discontinued, the patient's A1C returned to its previous baseline value. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's low AIC level and his ribavirin-peginterferon alfa-2b therapy. Clinicians should be aware that combination therapy for hepatitis C may affect A1C values. To maintain accurate glucose control in patients with diabetes who are receiving treatment for hepatitis C, it is important that they self-monitor their blood glucose levels in conjunction with A1C data, especially when A1C values become falsely low.
authors.affiliation: Department of Clinical Pharmacy, University of Tennessee Health Science Center, Kingsport, Tennessee, USA. bgross@utmem.edu
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Gross
authors.forename: L Brian
authors.initials: LB
authors.lastname: Cross
authors.forename: Joni C
authors.initials: JC
authors.lastname: Foard
authors.forename: Yelena A
authors.initials: YA
authors.lastname: Wood
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006526:Hepatitis C / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D006442:Glycated Hemoglobin; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin; C517652:hemoglobin A1c protein, human; C417083:peginterferon alfa-2b