RIBAVIRIN IMPAIRS SALIVARY GLAND FUNCTION IN HEPATITIS C PATIENTS DURING COMBINATION TREATMENT WITH PEGYLATED INTERFERON ALFA-2A

摘要

Background: Xerostomia is a common adverse event of unknown etiology observed during pegylated interferon (PegIFN) /Ribavirin (Rbv) treatment.Objectives: To assess the frequency and mechanisms of xerostomia during PegIFN/Rbv therapy.Patients and Methods: Thirty-one naive patients with chronic hepatitis C consecutively received PegIFN- a 2a (180 m g/week) plus Rbv (800–1200 mg/day). The controls were 10 patients with chronic hepatitis B who received PegIFN- a 2a (180 μg/week). During treatment and follow-up, all patients underwent basal and masticatory stimulated sialometry, otorhinolaryngoiatric (ORL) examination, and a questionnaire survey to subjectively assess symptoms of oral dryness.Results: Twenty-seven patients on PegIFN/Rbv and 4 on PegIFN (87% vs.40%, P=0.006) reported xerostomia. Thirty patients on PegIFN/Rbv combination therapy and 2 patients on monotherapy had ORL signs of salivary gland hypofunction (97%vs.20%, PMean basal (A) and stimulated (B) salivary flow rates (mL/min) progressively decreased during PegIFN/Rbv treatment (A, 0.49 at baselinevs.0.17 at the end of treatment, PConclusions: Rbv causes salivary gland hypofunction in hepatitis C patients receiving PegIFN/Rbv therapy, which promptly reverts to normal upon cessation of treatment.