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Management of adverse effects of Peg-IFN and ribavirin therapy for hepatitis C

Mark S Sulkowski1, Curtis Cooper, Bela Hunyady

  • 1Viral Hepatitis Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. msulkowski@jhmi.edu

Nature Reviews. Gastroenterology & Hepatology
|March 10, 2011
PubMed

Insights

Hepatitis C (HCV) treatment with Peg-IFN and ribavirin causes significant adverse effects across organ systems. Effective management strategies are crucial for successful HCV eradication and patient adherence.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pharmacology

Background:

  • Hepatitis C virus (HCV) infection affects 2-3% of the global population, leading to end-stage liver disease and hepatocellular carcinoma.
  • Pegylated interferon-alpha (Peg-IFN) and ribavirin combination therapy offers a 40-90% cure rate for HCV but is limited by frequent, serious adverse effects.
  • Adverse effects significantly impact treatment adherence, with higher discontinuation rates in clinical practice compared to clinical trials.

Purpose of the Study:

  • To systematically review the adverse effects of Peg-IFN-α and ribavirin on multiple organ systems.
  • To recommend consensus-based management strategies for these adverse effects.
  • To improve the successful treatment and delivery of HCV therapy.

Main Methods:

  • Comprehensive literature review of Peg-IFN-α and ribavirin therapy.
  • Systematic description of adverse effects across organ systems.
  • Analysis of regional and global variability in adverse effect management.

Main Results:

  • Peg-IFN and ribavirin cause off-target effects impacting most organ systems, including hematologic, dermatologic, neurologic, immunologic, gastrointestinal, pulmonary, cardiovascular, and ocular.
  • Adverse effects are a major barrier to treatment, leading to discontinuation in 10-15% of patients in trials and higher rates in practice.
  • Variability exists in reported adverse effects and management strategies globally.

Conclusions:

  • Effective recognition and management of Peg-IFN and ribavirin adverse effects are critical for successful chronic HCV treatment.
  • Consensus approaches to managing these side effects are needed to optimize patient outcomes.
  • Addressing adverse effects can improve treatment uptake, delivery, and adherence, ultimately enhancing HCV eradication rates.

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