Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 5-6, Pages: 320-324
https://doi.org/10.2298/SARH1306320F
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Extrahepatic manifestations of chronic hepatitis C and their influence on response to treatment with Pegylated interferon alfa-2a and ribavirin
Fabri Milotka (Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad)
Ružić Maja (Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad)
Lendak Dajana (Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad)
Preveden Tomislav (Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad)
Fabri Izabela (Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad)
Petrić Vedrana (Klinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad)
Introduction. Thirty to 50% of patients with chronic hepatitis C (CHC) have
one or more extrahepatic manifestations (EHMs) of hepatitis C virus (HCV)
infection. Objective. The aim of this study was to evaluate the frequency of
EHMs and to investigate the efficacy of pegylated interferon (PegIFN)α2a
plus ribavirin therapy in patients with HCVrelated EHMs. Methods. The study
included 280 patients suffering from CHC and treated with PegIFNα2a and
ribavirin. The patients were divided in two groups according to presence or
absence of EHMs. We evaluated virological response to antiviral therapy.
Results. One or more EHMs were found among 27.9% of patients. Most frequently
they had rheumatoid factor in serum (12.5%), organnonspecific antibodies ANA
and AGMA (12.4%), thyroid hormone disorders (9.3%), vasculitis (5.7%),
diabetes mellitus (4.65%), glomerulonephritis (0.71%), and porphyria cutanea
tarda (0.36%). Among the patients with EHMs there was 52.6% of females vs.
30.2% of females in the group of patients without EHMs (p=0.001). HCV
genotypes 1 and 4 had 85.9% patients with EHMs vs. 58.4% of patients without
EHMs (p=0.000). Progressive fibrosis and cirrhosis were more frequently
recorded in the EHM group of patients (32% vs. 23.2%), but without
statistically significant difference (p=0.532). Serious adverse events of
PegIFNα2a and ribavirin were statistically significantly recorded among
the patients with EHMs (46.1% vs. 12.9%; p=0.000). Sustained virological
response among the patients with and without EHMs rated 56.9% and 70.8%
respectively (p=0.125). Conclusion. Patients with CHC and EHMs treated with
combined PegIFNα2a and ribavirin experience handling difficulties, more
often have serious adverse events, while successful outcome is achieved in
about 50% of patients.
Keywords: chronic hepatitis C, extrahepatic manifestations, autoimmune hepatitis