Predictive factors for adverse dermatological events during pegylated/interferon alpha and ribavirin treatment for hepatitis C.
BACKGROUND
Treatment of chronic hepatitis C (CHC) with pegylated interferon-alpha/ribavirin is associated with well-characterized dermatological adverse events (AEs), which can lead to premature discontinuation of treatment.


OBJECTIVE
To investigate the incidence and spectrum of dermatological AEs during CHC treatment with interferon-alpha plus ribavirin and analyzed factors predisposing patients to such reactions.


METHODS
Between January 2008 and December 2012, 152 CHC patients who had received interferon/pegylated interferon plus ribavirin therapy were enrolled in this retrospective study. To determine which factors were associated with dermatological AE development, a Cox proportional-hazards regression analysis was performed.


RESULTS
Thirty dermatological AEs were recorded in 28 (18.4%) patients. These reactions included 14 (9.2%) patients with eczematous reactions, four (2.6%) patients with xerosis, three (2.0%) patients with new-onset or exacerbation of psoriasis, two (1.3%) patients with lichenoid eruption, two (1.3%) patients with diffuse folliculitis and one patient with lichen planus, alopecia areata, hypermelanosis, and necrosis of the skin and toenails. Application of the Cox proportional-hazards model revealed that age older than 60 years (HR=1.070; 95% CI: 1.043-1.096), pre-existing anaphylaxis/skin disease (HR=2.612; 95% CI: 1.593-3.324), cirrhosis (HR=1.863; 95% CI: 1.047-3.013), and treatment with pegylated interferon formulations (HR=1.930; 95% CI: 1.052-3.687) were associated with occurrence of dermatologic AEs. Twenty-seven (90%) skin conditions were classified as mild to moderate, while one case (3.3%) warranted premature discontinuation of treatment.


CONCLUSIONS
Dermatological AEs resulting from interferon-alpha/ribavirin treatment of CHC contribute to a wide spectrum involve the skin, mucous membrane, hair, and nails. These dermatological AEs correlated with older age, previous skin condition, cirrhosis, and use of pegylated interferon formulations.
Department of Dermatology, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Zhengxiao
Z
Li
Department of Dermatology, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Yanfei
Y
Zhang
Department of Dermatology, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Jingang
J
An
Department of Dermatology, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Yiguo
Y
Feng
Department of Infectious Diseases, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Hong
H
Deng
Department of Dermatology, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China.
Shengxiang
S
Xiao
Department of Infectious Diseases, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, PR China. Electronic address: jifanpu1979@163.com.
Fanpu
F
Ji
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D012871:Skin Diseases / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
Adverse skin reactions; Chronic hepatitis C; Pegylated interferon alpha; Ribavirin