PSORIASIS SHOULD NOT BE A CONTRAINDICATION TO INTERFERON THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C

Abstract

Purpose: The purpose of the study was to determine the safety and efficacy of interferon therapy on psoriasis in hepatitis C patients treated with interferon. Psoriasis, as an autoimmune condition, has been considered a contraindication to interferon therapy in chronic hepatitis C. Methods: A retrospective review of 100 charts of patients with Hepatitis C at an outpatient tertiary liver clinic was performed. 6 patients were identified who had psoriasis and received interferon therapy. A systematic chart review was performed; age, sex, and biopsy results were obtained. The type and duration of therapy was also reviewed including the response to treatment and psoriatic flares during treatment. Results: Of the 6 patients, 4 were male and 2 were females. The majority of patients had advanced liver disease, either bridging fibrosis (2) or cirrhosis (3). Treatment duration ranged from 24 to 96 weeks with either conventional interferon 3/week or pegylated interferon, or both. 3/6 patients had a sustained virologic response (SVR) with therapy. While 2 patients had a worsening of their psoriasis, it had little impact on their treatment since they were able to complete a full course of treatment. One patient who had a SVR has actually had complete resolution of his psoriasis while on treatment that has still not reappeared 6 months after stopping treatment. Conclusions: Interferon therapy for Hepatitis C patients did not have a clinically significant impact on their psoriasis. Patients were able to tolerate the standard duration of therapy and obtain a SVR in 33% of those treated. Patients with psoriasis and Hepatitis C, especially those with advanced his-tologic liver disease, should be considered for interferon therapy in order to prevent progression to cirrhosis and its deadly consequences. Psoriasis should not be considered a contraindication to interferon therapy in patients with hepatitis C.Table 1