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Side effects of high-dose INF therapy for HCV - Mass study

Various side effects have been reported in patients treated with alpha IFN, but their incidence and prognosis remain unknown.

AIM : The aim of this study was to determine the incidence and prognosis of various side effects of \alpha IFN in the patients with chronic active hepatitis C (CAH-C) and the predisposition for various side effects of \alpha IFN. 10 MU of \alpha IFN per day for 2 weeks and three times weekly for 22 weeks . Autoantibodies, thyroid function tests, and fasting plasma glucose were evaluated prior to IFN therapy.

RESULTS : Of the 971 patients, 307 were required reduction in the dose of IFN to 3MU/day or cessation because of adverse reactions such as flu-like symptoms, leukopenia, and thrombocytopenia. Of the remaining 664, 5 developed diabetes mellitus, 11 had hyperthyroidism, and 6 acquired hypothyroidism. Of the 17 with thyroid disorders, 5 demonstrated microsomal antibody before therapy. Forty-three patients revealed high or low concentrations of TSH at the end of IFN therapy. Three patients developed interstitial pneumonia, one acquired SLE-like symptom , 2 had autoimmune hepatitis , 2 developed rheumatoid arthritis , and one developed autoimmune thrombocytopenic purpura. No patients had a history of an autoimmune disorder. Melena was seen in 3 patients of which 2 were compatible with ischemic colitis. Symptoms of depression were noted in 11 patients and one manifested memory loss. Skin rash with itching was noted in 84 and 201 patients reported the development of falling-out of hair.

CONCLUSION : High-dose\alpha IFN therapy induces various adverse effects. Most of the side effects cannot be predictive, but are reversible.

T Okanoue, S Sakamoto, Y Itoh, M Minami, Y Yasui, M Sakamto, K Nishioji, and K Kashima. Third Dept. of Int. Med., Kyoto Pref. Univ. of Med., Kyoto, Japan.

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