SIDE EFFECTS OF COMBINATION OF INTERFERON PLUS RIBAVIRIN THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C; AN EXPERIENCE WITH 400 PATIENTS

Objective: To assess the side effects of combination therapy of interferon plus ribavirin in chronic hepatitis Cpatients.Material and Methods: This prospective observational study was conducted in Medical unit DHQ hospital Daggar and a private clinic ofconsultant physician in Peshawar from January2001 to June 2004.A total of400patients ofchronic hepatitis C with positive Anti HCV (hepatitis C virus) antibodies andHCV RNA by polymerase chain reaction (PCR) were enrolled in the study These patients received combination therapy ofinterferon plus ribavirin for six months. During each visit these patients were assessed for various unwanted effects related to the treatment. These side effects were graded as mild moderate and severe.Result: The imst common side effects observed in our patients were haematological in 92.5% (n=370), flu like symptoms in 91% (n=364), gastro intestinal in 88.5% (n=354), dermatological in 81.5% (n=326), neuropsychiatric in71.25%(n=285), respiratory symptoms in 14%> (n=57), thyroid function abnormalities in 4%0 (n=16), major depression in 1%> (n=4) and suicide attempt in 0.5% (n=2). Most ofthe side effects were mild to moderate. The severe adverse effects that led to reduction in dose or withdrawal oftreatment were noted in 50 (12.5%) patients.Conclusion: Treatment ofhepatitis C with combination therapy is not without harmful effects. Most ofthe side effects are attributed to interferon and some to ribavirin