Hearing profile in hepatitis C virus patients under dual treatment with interferon and ribavirin

Abstract

Objective: To study the effect of dual therapy with interferon and ribavirin on hearing in chronic HCV patients treated with these medications. Study design: This was a cross-sectional study in which assessment of hearing and cochlear function was carried out using pure tone audiometry and transient otoacoustic emissions (TEOAEs). Thirty young-aged adult patients with chronic active hepatitis C virus (HCV) received dual treatment with interferon and ribavirin for at least three months. They were compared to 30 chronic HCV patients for whom treatment was not applicable. Results: HCV patients under treatment exhibited a mild high-frequency sensorineural hearing loss (SNHL) in 63.3% of subjects (unilateral in 36.7% and bilateral in 26.7% of subjects). HCV patients not receiving treatment showed SNHL, which was unilateral in 13.3% of subjects. In HCV patients under treatment 33% of subjects had a bilateral TEOAE pass and 30% of subjects had a unilateral pass (unilateral partial pass). The remaining 37% of subjects had a bilateral partial pass, compared to a bilateral pass in 96.67% of subjects not receiving treatment. There was a statistically significant difference between the two groups with regard to the hearing threshold at different frequencies and TEOAE overall wave reproducibility in both ears. Normal hearing ears of those with a unilateral SNHL showed a lower pass rate (27.3%) than those of the bilateral normal hearing group (54.5%), which suggests subtle changes in their cochleae. Conclusion: Dual interferon and ribavirin therapy for HCV patients could damage the cochlear outer or inner hair cells.