Telaprevir-induced, but not pegylated interferon-associated, retinopathy as a noteworthy adverse effect during triple antiviral therapy in patients with chronic hepatitis C

摘要

Background: The significance of retinopathy during triple therapy with telaprevir is uncertain. Methods: Ophthalmologic examination was done prospectively before and every month during the therapy in 95 CHC patients. Results: Retinopathy was found in 46 (48.4 %), and the specialists recommended discontinuation of the therapy in 9 (9.5 %). Such lesions may develop as adverse effects by telaprevir, since the lesions disappeared following discontinuation of telaprevir in a 65-year-old man, in whom both pegylated-interferon (Peg-IFN) and ribavirin were continued, and reappeared when he took telaprevir again by his decision. Multivariate analysis revealed that interleukin 28B single-nucleotide polymorphism (IL28B SNP) and anemia development during the therapy were independent factors associating retinopathy. Conclusion: Ophthalmologic examinations should be done carefully during triple therapy, since the incidence was higher than that in previous Peg-IFN therapy, and lesions may develop as adverse effects by telaprevir, but not by Peg-IFN, especially in those showing preferable IL28B SNPs allele and/or anemia during the therapy.