Onur URAL, , Nazlım AKTUĞ DEMİR, Şua SÜMER, Gaye URAL, Mehmet BALCI

Kronik Hepatit C İnfeksiyonda Pegileinterferon Alfa 2A ve Ribavirin Kombinasyonu ile İnterferon Alfa 2A ve Ribavirin Kombinasyonunun Yan Etkilerinin Karşılaştırılması

Amaç: Kronik hepatit C infeksiyonunda interferon alfa 2a ve ribavirin, pegile interferon alfa 2a ve ribavirin kombinasyonuna bağlı oluşan yan etkiler karşılaştırıldı.Hastalar ve Yöntemler: Bu çalışmada, haftada üç kez 3 milyon U subkutan interferon alfa 2a ve 1000-1200 mg/gün oral ribavirin alan 36 hasta ile haftada bir subkutan 180 µgr pegile interferon alfa 2a ve 1000-1200 mg/gün oral ribavirin alan 49 hasta ile ilişkili yan etkiler karşılaştırıldı.Bulgular: Pegile interferon alfa grubunda en sık görülen yan etkiler iştahsızlık, baş ağrısı, ve yorgunluktur. Bu fark gruplar arasında istatistiksel olarak anlamlıdır (p < 0.05). Sonuç: Çalışmamızda interferon ve ribavirin alan 2 hastada (bir hastada anemi, diğer hastada anemi ve trombositopeni) pegile interferon ve ribavirin alan üç hastada (bir hastada anemi, bir hastada anemi ve trombositopeni, diğerinde psikiyatrik problemler) tedavi kesildi.

Anahtar Kelimeler:

Pegile interferon alfa 2a + ribavirin, interferon alfa 2a + ribavirin, yan etki.

Comparision of the Side Effects Due To Interferon Alpha 2A Plus Ribavirin and Pegylated Interferon Alpha 2A Plus Ribavirin Combinations For Chronic Hepatitis C Infection

Keywords:

Pegylated interferon alpha 2a + ribavirin; interferon alpha 2a + ribavirin; side effects,

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Demir K. Kronik C hepatiti tedavisinin yan etkileri ve teda- vileri. Nobel Medikus 2003;3:27-8.
Ökten A, Demir K, Kaymakoğlu S, Çakaloğlu Y, Dinçer D, Beşışık F. Kronik hepatitlerin etyolojik dağılımı. Turk J Gastroenterol 1998;2:113-5.
Gürel S. Kronik Viral Hepatitlerin İnterferon alfa teda- visinde görülen yan etkiler. Viral Hepatit Dergisi 1998;2:98- 100.
Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Gonçales FL Jr, et al. Peginterferon alfa-2a plus ribavi- rin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975-82.
Dincer D. Kronik C hepatiti tedavisinin yan etkileri ile muc- adele. Guncel Gastroenteroloji 2005;9:258-64.
Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Marcellin P, et al. Peginterferon-alpha2a and ribavirin com- bination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140:346-55.
Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 2001;358:958-65.
McHutchison JG, Manns M, Patel K, Poynard T, Lindsay KL, Trepo C, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology 2002;123:1061-9.
Dincer D, Demir K, Kaymakoglu S, Cakaloglu Y, Besisik F, Durakoglu Z, ve ark. Kronik viral hepatit tedavisinde interferonun hematolojik parametrelere etkisi. Viral Hepatit Dergisi 2000;6:172-4.
Fried MW, Hoofnagle JH. Therapy of hepatitis C. Semin Liver Dis 1995;15:82-91.
Russo MW, Fried MW. Side effects of therapy for chronic hepatitis C. Gastroenterology 2003;124:1711-9.
Carella C, Mazziotti G, Morisco F, Manganella G, Rotondi M, Tuccillo C, et al. Long-term outcome of interferon-alpha- induced thyroid autoimmunity and prognostic influence of thyroid autoantibody pattern at the end of treatment. J Clin Endocrinol Metab 2001;86:1925-9.
Yuluğkural Z. Kronik C hepatiti tedavisinde yan etkilerle mücadele; anemi, lökopeni, trombositopeni. Hepatit C gün- celleme toplantısı 167-8.
Kowdley KV. Hematologic side effects of interferon and rib- avirin therapy. J Clin Gastroenterol 2005;39(1 Suppl):S3-8.
Collantes RS, Younossi ZM. The use of growth factors to manage the hematologic side effects of PEG-interferon alfa and ribavirin. J Clin Gastroenterol 2005;39(1 Suppl):S9-13.
Carreño V, Martín J, Pardo M, Brotons A, Anchía P, Navas S, et al. Randomized controlled trial of recombinant human granulocyte-macrophage colony-stimulating factor for the treatment of chronic hepatitis C. Cytokine 2000;12:165-70.
Sulkowski MS. Management of the hematologic complica- tions of hepatitis C therapy. Clin Liver Dis 2005;9:601-16.
De Franceschi L, Fattovich G, Turrini F, Ayi K, Brugnara C, Manzato F, et al. Hemolytic anemia induced by ribavirin therapy in patients with chronic hepatitis C virus infec- tion: role of membrane oxidative damage. Hepatology 2000;31:997-1004.
Afdhal NH, Dieterich DT, Pockros PJ, Schiff ER, Shiffman ML, Sulkowski MS, et al. Epoetin alfa maintains ribavirin dose in HCV-infected patients: a prospective, double- blind, randomized controlled study. Gastroenterology 2004;126:1302-11.
Schramm TM, Lawford BR, Macdonald GA, Cooksley WG. Sertraline treatment of interferon-alfa-induced depressive disorder. Med J Aust 2000;173:359-61.
Hauser P. Neuropsychiatric side effects of HCV therapy and their treatment: focus on IFN alpha-induced depres- sion. Gastroenterol Clin North Am 2004;33(1 Suppl):S35-50.
Aspinall RJ, Pockros PJ. The management of side-effects during therapy for hepatitis C. Aliment Pharmacol Ther 2004;20:917-29.