Sudden hearing loss in patients with chronic hepatitis C treated with pegylated interferon/ribavirin.
- Am J Gastroenterol. 2004 May;99(5):873-7. Related Articles, Links
Sudden hearing loss in patients with chronic hepatitis C treated with
Formann E, Stauber R, Denk DM, Jessner W, Zollner G, Munda-Steindl P,
Gangl A, Ferenci P.
Department of Internal Medicine IV, Gastroenterology and Hepatology,
University of Vienna, Austria.
BACKGROUND: Sudden hearing loss has been reported on standard
interferon (IFN)-alpha2 therapy. This is the first report on the
occurrence of sudden hearing loss in six cases of chronic hepatitis C
in temporal relation to treatment with pegylated (PEG)-IFN alfa2a or
b/ribavirin combination therapy. Three patients were treated in an
ongoing randomized placebo-controlled trial comparing the addition of
200 mg amantadine or placebo to the combination of 180 microg PEG-IFN
alpha2a (PEGASYS((R)), Roche, Basel, CH)/wk and 1-1.2 g ribavirin/d
(COPEGUS((R)), Roche, Nutley, USA) in de novo patients infected with
HCV genotype 1. Sudden hearing loss and tinnitus developed on day 1
and after 4, 23, 25, 36, and 40 wk of treatment, respectively.
CONCLUSIONS: Sudden hearing loss may occur in about 1% of patients on
PEG-IFN/ribavirin combination therapy. This rate was not different to
that observed in an untreated population. Possible mechanisms
involved include direct ototoxicity of IFN, autoimmunity, and
hematological changes. In contrast to published cases on auditory
disability due to standard IFN, hearing loss did not fully resolve
after discontinuation of therapy with PEG-IFN. On the other hand,
symptoms did not worsen on continued treatment. Therefore, the
decision whether to continue or to stop the treatment when signs of
ototoxicity appear is based on the clinical judgment of the treating
PMID: 15128353 [PubMed - in process]
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