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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 21, 2006; 12(23): 3756-3759
Published online Jun 21, 2006. doi: 10.3748/wjg.v12.i23.3756
Risk factors for retinopathy associated with interferon α-2b and ribavirin combination therapy in patients with chronic hepatitis C
Chiaki Okuse, Hiroshi Yotsuyanagi, Yoshihiko Nagase, Yuhtaro Kobayashi, Kiyomi Yasuda, Kazuhiko Koike, Shiro Iino, Michihiro Suzuki, Fumio Itoh
Chiaki Okuse, Yoshihiko Nagase, Yuhtaro Kobayashi, Michihiro Suzuki, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, 216-8511, Japan
Hiroshi Yotsuyanagi, Kazuhiko Koike, Department of Infectious Diseases, Internal Medicine, Faculty of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo 113-8655, Japan
Kiyomi Yasuda, Shiro Iino, Center for Liver Diseases, Kiyokawa Hospital, Minamiasagaya, Suginami, Tokyo, 166-0004, Japan
Correspondence to: Dr. Hiroshi Yotsuyanagi, Department of Infectious Diseases, Internal Medicine, Faculty of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo 113-8655, Japan. hyotsu-tky@umin.ac.jp
Telephone: +81-3-58008720 Fax: +81-3-58008796
Received: January 13, 2006
Revised: January 28, 2006
Accepted: February 18, 2006
Published online: June 21, 2006
Abstract

AIM: To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy.

METHODS: We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy.

RESULTS: Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR = 245.918, 95% CI = 5.6-10786.2).

CONCLUSION: Retinopathy associated with combination therapy of interferon α-2b and ribavirin tends to develop in patients with hypertension.

Keywords: Retinopathy; Ribavirin; Chronic hepatitis C; Interferon