Abstract
Interferon monotherapy is less effective against chronic hepatitis C when it is caused by the genotype lb virus, which is highly prevalent in Japan. For this reason, combination therapy comprising interferon and ribavirin has recently been introduced, but this new therapy often causes serious adverse effects. This study was undertaken to characterize the adverse effects in 25 patients who underwent combination therapy in the Department of Gastroenterology of Sapporo City General Hospital. All the patients complained of pyrexia and malaise in the initial stage (1 to 4 weeks) of the therapy. Adverse effects occurring in the mouth, however, such as dysgeusia, increased saliva viscosity, and stomatitis, occurred preferentially 4 weeks after the start of the therapy. In patients who discontinued the combinationtherapy, hemoglobin levels decreased significantly, by more than 30%, compared with before treatment, and the incidences of malaise, anorexia and depression were significantly higher than those in patients who completed the therapy. Further, two weeks after the start of the combination therapy, serum ribavirin levels had increased to more than 2000ng/mL, and levels at this stage tended to be higher than those in patients who completed the therapy. Therefore, to prevent patients from discontinuing such combination therapy, it is necessary to monitor adverse effects as well as hemoglobin and ribavirin levelsat the initial stage.
