August 2, 2012
For patients with hepatitis C virus treated with pegylated interferon alpha and ribavirin, retinopathy occurs frequently, especially in those with hypertension, according to a study published in the August issue of Hepatology.
Stela Vujosevic, M.D., from IRCCS in Rome, and colleagues examined the frequency and clinical significance of retinopathy in 97 consecutive HCV patients treated with PegIFNα and ribavirin. Ophthalmologic examination was performed before therapy initiation (baseline), at three and six months (3T and 6T) of therapy, and three months after the end of therapy (3ET). The researchers found that 55.7 percent of patients were treated with PegIFNα 2a and 44.3 percent were treated with PegIFNα 2b. Retinopathy developed in 30.9 percent of patients. Age, metabolic syndrome, hypertension, cryoglobulinemia, and preexisting intraocular lesions at baseline were significantly associated with retinopathy during treatment. Hypertension was the only variable independently associated with PegIFNα-associated retinopathy on multivariate analysis (hazard ratio, 4.99).
Retinopathy was significantly more frequent in patients with hypertension versus those without hypertension, at all time points (18.5 versus 5.7 percent at baseline; 48.1 versus 15.7 percent at 3T; 68.0 versus 19.1 percent at 6T; 32.0 versus 6.2 percent at 3ET). Compared with thyroid-stimulating hormone screening, screening for PegIFNα-associated retinopathy was deemed cost-effective. "Retinopathy is frequent during treatment with PegIFNα and ribavirin, especially in hypertensive patients, who may develop serious complications," the authors write.
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Journal reference: Hepatology
Copyright © 2012 HealthDay. All rights reserved
Pegylated interferon-associated retinopathy is frequent in hepatitis C virus patients with hypertension and justifies ophthalmologic screening†
Stela Vujosevic1
Hepatology
Treatment with pegylated interferon alpha (PegIFNα) and ribavirin is still
regarded as the standard of care for chronic hepatitis C virus (HCV).
Retinopathy has been occasionally described but prospective, longitudinal data
are lacking.
We investigated the frequency and clinical significance of retinopathy during therapy with PegIFNα and ribavirin in 97 consecutive HCV patients. In all, 54 (55.7%) and 43 (44.3%) patients were treated with PegIFNα 2a and PegIFNα 2b, respectively. Ophthalmologic examination was performed before therapy (baseline), at 3 and 6 months (3T and 6T, respectively) of therapy, and 3 months after the end of therapy (3ET).
All patients underwent the baseline and 3T examination, 95.9% and 90.7% of patients underwent 6T and 3ET examination, respectively. Overall, 30.9% of patients developed retinopathy, as defined by the presence of cotton wool spots and/or retinal hemorrhages. Variables significantly associated with retinopathy during treatment were age (P = 0.004), metabolic syndrome (P = 0.05), hypertension (P < 0.0001), cryoglobulinemia (P = 0.05), and preexisting intraocular lesions at baseline (P = 0.01). By multivariate analysis, the only variable independently associated with PegIFNα-associated retinopathy was hypertension (hazard ratio [HR] = 4.99, 95% confidence interval [CI] 2.29-10.89). The frequency of retinopathy was significantly higher in hypertensive patients versus those without hypertension at all timepoints (18.5% versus 5.7% at baseline, P = 0.05; 48.1% versus 15.7% at 3T, P = 0.0009; 68.0% versus 19.1% at 6T, P < 0.0001; 32.0% versus 6.2%, P = 0.0005 at 3ET). In one (1.1%) hypertensive patient, who developed bilateral branch retinal vein occlusion at 6T, the therapy was discontinued. A cost analysis showed that screening for PegIFNα-associated retinopathy was cost-effective as compared with thyroid-stimulating hormone screening.
Conclusion: Retinopathy is frequent during treatment with PegIFNα and ribavirin, especially in hypertensive patients, who may develop serious complications. Screening for PegIFNα-associated retinopathy should be recommended for HCV patients with hypertension. (HEPATOLOGY 2012)
We investigated the frequency and clinical significance of retinopathy during therapy with PegIFNα and ribavirin in 97 consecutive HCV patients. In all, 54 (55.7%) and 43 (44.3%) patients were treated with PegIFNα 2a and PegIFNα 2b, respectively. Ophthalmologic examination was performed before therapy (baseline), at 3 and 6 months (3T and 6T, respectively) of therapy, and 3 months after the end of therapy (3ET).
All patients underwent the baseline and 3T examination, 95.9% and 90.7% of patients underwent 6T and 3ET examination, respectively. Overall, 30.9% of patients developed retinopathy, as defined by the presence of cotton wool spots and/or retinal hemorrhages. Variables significantly associated with retinopathy during treatment were age (P = 0.004), metabolic syndrome (P = 0.05), hypertension (P < 0.0001), cryoglobulinemia (P = 0.05), and preexisting intraocular lesions at baseline (P = 0.01). By multivariate analysis, the only variable independently associated with PegIFNα-associated retinopathy was hypertension (hazard ratio [HR] = 4.99, 95% confidence interval [CI] 2.29-10.89). The frequency of retinopathy was significantly higher in hypertensive patients versus those without hypertension at all timepoints (18.5% versus 5.7% at baseline, P = 0.05; 48.1% versus 15.7% at 3T, P = 0.0009; 68.0% versus 19.1% at 6T, P < 0.0001; 32.0% versus 6.2%, P = 0.0005 at 3ET). In one (1.1%) hypertensive patient, who developed bilateral branch retinal vein occlusion at 6T, the therapy was discontinued. A cost analysis showed that screening for PegIFNα-associated retinopathy was cost-effective as compared with thyroid-stimulating hormone screening.
Conclusion: Retinopathy is frequent during treatment with PegIFNα and ribavirin, especially in hypertensive patients, who may develop serious complications. Screening for PegIFNα-associated retinopathy should be recommended for HCV patients with hypertension. (HEPATOLOGY 2012)
Read more at: http://medicalxpress.com/news/2012-08-hypertension-ups-retinopathy-hcv-treatment.html#jCp
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