Romanian Society of Pharmaceutical Sciences

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AUTOIMMUNE DISORDERS DUE TO DOUBLE ANTIVIRAL THERAPY WITH PEGINTERFERON AND RIBAVIRIN IN PATIENTS WITH HEPATITIS C VIRUS INFECTION

ANCA OANA DOCEA 1#, ELIZA GOFITA 1#*, DANIELA CALINA 2#, ZAHARIE SORIN IOAN 3#, DANIEL IONICA VALCEA 4#, PAUL MITRUT 5#

1.Toxicology Department, University of Medicine and Pharmacy, Faculty of Pharmacy, 2 Petru Rares, 200349, Craiova, Romania
2.Clinical Pharmacy Department, University of Medicine and Pharmacy, Faculty of Pharmacy, 2 Petru Rares, 200349, Craiova, Romania
3.Nephrology Department, University of Medicine and Pharmacy, Faculty of Medicine, 2 Petru Rares, 200349, Craiova, Romania
4.2nd Surgical Department, University of Medicine and Pharmacy, Faculty of Medicine, 2 Petru Rares, 200349, Craiova, Romania
5.Internal Medicine Department, University of Medicine and Pharmacy, Faculty of Medicine, 2 Petru Rares, 200349, Craiova, Romania

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During antiviral therapy with peginterferon and ribavirin in chronic hepatitis C, severe adverse events were reported in 10 - 20% of cases. Among these, autoimmune adverse events are severe even if they are rarely reported. In this study we aimed to highlight the type, incidence and biological profile of autoimmune disorders that may occur during double antiviral therapy. We investigated 320 patients with chronic hepatitis C virus infection treated with double anti-viral therapy with peginterferon plus ribavirin between February 2012 and April 2015 in the Medical Clinic II of the Emergency Regional Hospital Craiova, Romania. The incidence of autoimmune adverse events in the study group was reported in 1.87% of cases (6 patients). Thyroid disorders have been reported in 2 cases, rheumatoid arthritis in 2 cases, systemic lupus erythematosus in 1 case and in 1 case autoimmune thrombocytopenia. In all these cases, it was necessary to permanently stop the antiviral therapy and to initiate specific treatment. The determination of a broad spectrum of antibodies (anti-platelet autoantibodies, anti-double – stranded deoxyribonucleic acid (DNA) antibodies, anti-Thyroperoxidase (anti-TPO) levels, anti-mitochondrial antibodies, anti-liver-kidney microsomal antibodies type 1 (Anti-LKM-1 antibodies), anti-neutrophil cytoplasmic antibodies) is absolutely necessary and helps to diagnose of these autoimmune disorders.