Review Article

Evolution of Interferon-Based Therapy for Chronic Hepatitis C

Table 1

Contraindications and adverse effects of hepatitis C therapy.

Contraindications

Absolute contraindicationsMajor, uncontrolled depressive illness; autoimmune hepatitis or other condition known to be exacerbated by interferon and ribavirin; untreated hyperthyroidism; pregnant or unwilling/unable to comply with adequate contraception; severe concurrent disease such as severe hypertension, heart failure, significant coronary artery disease, poorly controlled diabetes, obstructive pulmonary disease; under 3 years of age; known hypersensitivity to drugs used to treat HCV

Relative contraindicationsDecompensated liver disease; solid organ transplantation (except liver); coexisting medical conditions: severe anemia (hemoglobin level < 100 g/L), neutropenia (neutrophil count < 0.75 × 109/L), thrombocytopenia (platelet count < 40 × 109/L), hemoglobinopathy, uncontrolled heart disease (angina, congestive heart failure, significant arrhythmias), cerebrovascular disease, advanced renal failure (creatinine clearance < 50 mL/min)

Adverse effects

Interferon or peginterferonFlu-like symptoms (fever, fatigue, myalgia and headaches); mild bone marrow suppression (especially, leucopenia and thrombocytopenia); gastrointestinal manifestation (anorexia, nausea, vomiting and diarrhea); emotional effects (depression, irritability, difficulty concentrating, memory disturbance and insomnia); dermatological manifestation (skin irritation, rash and alopecia); autoimmune disorders (especially thyroid dysfunction); weight loss; tinnitus and hearing loss; retinopathy (usually not clinically significant); hyperglycemia; seizures; renal function impairment; pneumonitis.

RibavirinHemolytic anemia (dose dependent); cough and dyspnea; rash and pruritis; nausea; sinus disorders; teratogenicity.