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Chronic cough associated with interferon/ribavirin therapy for hepatitis C
P V Dicpinigaitis1, F R Weiner
1Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA. pdicpinigaitis@pol.net
Journal of Clinical Pharmacy and Therapeutics
|May 7, 2011
Summary
Hepatitis C treatment with pegylated interferon and ribavirin can cause a reversible increase in cough reflex sensitivity, leading to chronic cough. This effect is primarily attributed to ribavirin.
Area of Science:
- Hepatology
- Pharmacology
- Respiratory Medicine
Background:
- Pegylated interferon and ribavirin are standard treatments for chronic hepatitis C.
- Chronic cough is a reported side effect of this therapy, but its mechanism is unclear.
Observation:
- Four patients developed chronic cough during interferon/ribavirin therapy for hepatitis C.
- Cough resolved within weeks of completing treatment.
- Capsaicin cough challenge tests showed significantly enhanced cough reflex sensitivity during therapy.
Findings:
- Ribavirin, in combination with pegylated interferon, reversibly enhances cough reflex sensitivity.
- This enhanced sensitivity is the likely cause of treatment-related chronic cough.
Implications:
- Clinicians should consider this mechanism when patients on interferon/ribavirin therapy develop cough.
- Awareness can prevent unnecessary diagnostic workups for alternative cough causes.
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