Types and predictors of interferon/ribavirin induced cardiac complications in the Egyptian patients with chronic hepatitis C virus

Abstract

Background and aimInterferon-based therapy is known to be associated with significant side effects, including the cardiac complications; these may affect the patients’ adherence to therapy and consequently the response rate. The aim of this study was to detect types and predictors of interferon-induced cardiac complications in Egyptian hepatitis-C-virus-infected patients treated with pegylated interferon/ribavirin combination therapy. MethodsA total of 194, chronic hepatitis C virus (HCV) patients were followed up from the time of receiving treatment till one year after end of treatment, to detect cardiac disorders and to determine the response status. Patients were assessed by through history taking, full clinical examination, full evaluation of laboratory parameters, and cardiac assessment using the standard 12-lead electrocardiography and Transthoracic Doppler Echocardiography. Patients in the final analysis were divided into: group A (patients who developed cardiac disorders) and group B (patients who did not develop cardiac disorders). ResultsThe baseline clinical features (cardiovascular risk factors and hemodynamics) were comparable in both groups. Patients who developed cardiac disorders had higher baseline ALT level, hepatic fibrosis, and activity than patients without cardiac disorders (p<0.05). The confirmed cardiac complications represented 18.6% (n=36) and included left ventricular systolic and diastolic dysfunctions, pericardial effusion, arrhythmia, myocardial ischemia, and heart failure. Hepatic activity in the liver biopsy, ejection fraction, and left ventricular end-diastolic dimension were independent predictors for cardiovascular complications. ConclusionPegylated interferon therapy of chronic HCV is associated with many types of cardiac complications, predictors of which are higher baseline ALT, viral load, hepatic fibrosis, and hepatic histological activity index.