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4789Decreased bone mineral density after therapy with alpha interferon in combination with ribavirin for chronic hepatitis C

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  • claudine intexas
    Dec 2, 2000
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      Claudine

      NATAP
      www.natap.org
      --------------

      Decreased bone mineral density after therapy with
      alpha interferon in
      combination with ribavirin for chronic hepatitis C


      Journal of Hepatology 2000; 33: 812�817


      Jose� A. Soli�s-Herruzo 1 , Gregorio Castellano 1 ,
      Inmaculada Ferna�
      ndez 1
      , Raquel Mun� oz 1 and Federico Hawkins 2 of 1
      Gastroenterology and 2
      Endocrinology, Department of Medicine, Hospital
      Universitario ��12 de
      Octubre��, Universidad Complutense, Madrid, Spain


      As you may know, higher than normal rates of bone
      mineral density loss
      have
      been seen in HIV for people on HAART. Studies have
      suggested PI and
      NRTI
      therapy may be associated with BMD loss. As well,
      cytokine dysfunction
      has
      been hypothesized as associated with bone problems as
      well as with
      lipodystrophy.

      Background/Aims: Several thousand patients with
      chronic hepatitis C
      have been

      treated with interferon plus ribavirin. After
      observing a male patient
      who

      developed severe bone loss during this treatment, we
      studied skeletal
      status

      and bone mineral metabolism in patients on therapy
      with interferon plus

      ribavirin. Methods: Bone mineral density and
      biochemical bone

      markers were studied in 32 male patients (31�58 years
      old) treated for
      12

      months with either interferon alone (group 1; no13) or
      interferon plus

      ribavirin (group 2; no19).


      Results: Bone mineral density was significantly lower
      in group 2
      (0.877�0.07

      g/cm 2 ) than in group 1 (1.108�0.08 g/cm 2 ,
      p�0.001). Likewise, T- Z-
      and

      score values were also decreased in group 2 (T:
      �1.95�0.6. Z:
      �1.76�0.51)

      compared with group 1 (T: 0.19�0.6; p�0.001. Z:
      0.26�0.6; p�0.001).
      Serum and

      urine biochemical bone markers were nor-mal in both
      groups. However,
      urinary

      calcium excretion was decreased in patients on
      combined therapy.


      Conclusion: Treatment of chronic hepatitis C with
      interferon plus
      ribavirin

      may induce bone loss. This secondary effect should be
      investigated
      during the

      follow-up of these patients, since they may require
      therapies aimed at

      prevention or amelioration of these defects.


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