Irreversible pulmonary hypertension associated with the use of interferon alpha for chronic hepatitis C.
The interferons are a complex group of virally induced proteins produced by activated macrophages and lymphocytes, which have become the mainstay of therapy for hepatitis C infection. Sustained viral response (SVR) rates in noncirrhotic patients vary from 40-80% with interferon-based therapy. This, along with transplantation, has drastically changed the course of hepatitis C virus (HCV) infection over the last two decades. Numerous side effects associated with interferon therapy have been reported. These range from transient flu-like symptoms to serious effects such as cardiac arrhythmias, cardiomyopathy, renal and liver failure, polyneuropathy, and myelosuppression. Pulmonary side effects including pneumonitis, pulmonary fibrosis, and reversible pulmonary hypertension have been reported. Herein, we present four cases in which irreversible pulmonary hypertension was diagnosed after prolonged treatment with interferon alpha. In each case, other causes of pulmonary hypertension were systematically eliminated. Pulmonary artery hypertension, which may be irreversible, should be considered in patients being treated with interferon alpha who present with exertional dyspnea and do not have a readily identifiable inflammatory or thromboembolic cause.
Dhillon
Sonu
S
Department of Medicine, Rush University Medical Center, Ste. 158 Professional Building, Chicago, IL 60612, USA. sd7441@gmail.com
Kaker
Anshul
A
Dosanjh
Aneil
A
Japra
Deepa
D
Vanthiel
David H
DH
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004417:Dyspnea / Q000139:chemically induced; D017809:Fatal Outcome; D005260:Female; D006439:Hemodynamics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D000998:Antiviral Agents; D016898:Interferon-alpha
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