Side effects of combination of Interferon plus ribavirin therapy in patients with chronic hepatitis C; an experience with 400 patients

ABSTRACT

To assess the side effects of combination therapy of interferon plus ribavirin in chronic hepatitis C patients. Material and This prospective observational study was conducted in Medical unit DHQ hospital Daggar and a private clinic of consultant physician in Peshawar from January 2001 to June 2004. A total of 400 patients of chronic hepatitis C with positive Anti HCV [hepatitis C virus] antibodies and HCV RNA by polymerase chain reaction [PCR] were enrolled in the study. These patients received combination therapy of interferon plus ribavirin for six months. During each visit these patients were assessed for various unwanted effects related to the treatment. These side effects were graded as mild, moderate and severe. The most common side effects observed in our patients were haematological in 92.5% [n=370], flu like symptoms in 91% [n=364], gastro intestinal in 88.5% [n=354], dermatological in 81.5% [n=326], neuropsychiatric in 71.25%[n=285], respiratory symptoms in 14% [n=57], thyroid function abnormalities in 4% [n=16], major depression in 1% [n=4] and suicide attempt in 0.5% [n=2]. Most of the side effects were mild to moderate. The severe adverse effects that led to reduction in dose or withdrawal of treatment were noted in 50 [12.5%] patients. Treatment of hepatitis C with combination therapy is not without harmful effects. Most of the side effects are attributed to interferon and some to ribavirin