TYPES AND PREDICTORS OF INTERFERON/RIBAVIRIN INDUCED CARDIAC COMPLICATIONS IN THE EGYPTIAN PATIENTS WITH CHRONIC HEPATITIS C VIRUS

Abstract

Interferon-based therapy is associated with significant side effects, including the cardiac complications; these may affect the patients' adherence to therapy and consequently the response rate. The aim of this study was to detect the types and predictors of interferon induced cardiac complications in the Egyptian hepatitis C virus infected patients treated with pegylated interferon/ribavirin combination therapy.
Patients and Methods: A total of 194, chronic HCV patients were followed up from the time of receiving treatment till 6 months after the end of treatment, to detect cardiac disorders and to determine the response status. Patients were assessed by through history taking, full clinical examination, full laboratory parameters and cardiac assessment using the standard 12 lead ECG and Transthoracic Doppler Echocardiography. Patients in the final analysis were divided into: Group A (who developed cardiac disorders) and group B (who did not develop cardiac disorders).
Results: The baseline clinical features (cardiovascular risk factors and hemodynamics) were comparable in both groups. Patients who developed cardiac disorders had higher baseline ALT level, hepatic fibrosis and histologic activity in the liver biopsy than patients without cardiac disorders (P<0.05). The confirmed cardiac complications represented 18% (n=35) and included left ventricular systolic and diastolic dysfunction, pericardial effusion, arrhythmia and myocardial ischemia. Histological activity in the liver biopsy, ejection fraction (EF) and left ventricular end diastolic dimension (LVEDD) were independent predictors for cardiovascular complications.
Conclusion: Pegylated interferon therapy of chronic HCV is associated with many types of cardiac complications, predictors of which were histological activity in the liver biopsy, EF and LVEDD.
Key words: Pegylated Interferon; Hepatitis C virus; Cardiovascular complications of interferon.