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Risk factors for retinopathy associated with interferonα-2b and ribavirin combination therapy in patients with chronic hepatitis C
作者单位:Division of Gastroenterology and Hepatology Department of Internal Medicine St. Marianna University School of Medicine,Kawasaki,Kanagawa 216-8511,Japan,Department of Infectious Diseases,Internal Medicine,Faculty of Medicine,University of Tokyo,7-3-1,Hongo,Bunkyo,Tokyo 113-8655,Japan,Division of Gastroenterology and Hepatology,Department of Internal Medicine,St.Marianna University School of Medicine,Kawasaki,Kanagawa 216-8511,Japan,Division of Gastroenterology and Hepatology,Department of Internal Medicine,St.Marianna University School of Medicine,Kawasaki,Kanagawa 216-8511,Japan,Center for Liver Diseases,Kiyokawa Hospital,Minamiasagaya,Suginami,Tokyo,166-0004,Japan,Department of Infectious Diseases,Internal Medicine,Faculty of Medicine,University of Tokyo,7-3-1,Kongo,Bunkyo,Tokyo 113-8655,Japan,Center for Liver Diseases,Kiyokawa Hospital,Minamiasagaya,Suginami,Tokyo,166-0004,Japan,Division of Gastroenterology and Hepatology,Department of Internal Medicine,St.Marianna University School of Medicine,Kawasaki,Kanagawa,216-8511,Japan,Division of Gastroenterology and Hepatology,Department of Internal Medicine,St.Marianna University School of Medicine,Kawasaki,Kanagawa,216-8511,Japan
摘    要:AIM: To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy. METHODS: We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy. RESULTS: Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR=245.918, 95% CI=5.6-10786.2). CONCLUSION: Retinopathy associated with combination therapy of interferon a-2b and ribavirin tends to develop in patients with hypertension.

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