ADVERSE REACTIONS TO THE COMBINED THERAPY OF PEGINTERFERON ALPHA-2A AND RIBAVIRIN IN PATIENTS WITH CHRONIC HEPATITIS C

Objective: To describe the adverse reactions related to the combined therapy of peginterferon alpha-2a and ribavirin in patients with chronic hepatitis C. Method: Retrospective study of clinical records from 66 adult patients. Initial dosage: peginterferon alpha-2b (1.5 mu g/kg/week) or peginterferon alpha-2a (180 mu g/week); ribavirin (800 mg/day for genotypes 2 and 3 during 24 weeks) or 1,000-1,200 mg/day (<75 to >= 75 Kg for genotypes 1, 4 and 5, 48 weeks). Adverse reactions are described according to their type (hematologic and non-hematologic), frequency and severity. Results: 66 patients; 40.9% women, average age 48.0 years (standard deviation 10.6years), 25.8% younger-than-40 years, 80.3% of genotype 1b, NAIVE 69,7%. In 50% of patients, the initial dosage of one or both drugs was reduced due to hematologic reactions (19.7%), non-hematologic ones (19.7%), and both (10.6%). 51.5% of patients finished the treatment. 27.3% suspended treatment due to ineffectiveness, 16.7% due to adverse reactions and 4.5% due to medical decision. 93.9% showed hematologic alterations, mainly leukopenia, anemia and neutropenia. Frequency of non-hematologic adverse reactions: pseudo-influenza (69.7%), rash (31.8%), itch (28.8%), weight loss (28.8%), neuropsychiatric (27.3%) and gastrointestinal (27.3%). All of them were reversible with the exception of a febrile syndrome with adenopathies. Conclusions: There is a high frequency of adverse reactions caused by peginterferon and ribavirin. The frequency of severe reactions that forced treatment suspension was low (16.7%), and similar to that described on other published studies (5-15%). In some patients, a better and earlier handling of such reactions could improve treatment tolerance and effectiveness.