Alopecia universalis after discontinuation of pegylated interferon and ribavirin combination therapy for hepatitis C: a case report.

Abstract

For the last decade, the combination therapy of pegylated interferon (Peg-IFN) plus ribavirin (RBV) has been considered as the standard of care treatment for chronic hepatitis C virus (HCV) infection. However, it has been associated with an increased incidence of many adverse cutaneous reactions and emergence of autoantibodies or even autoimmune diseases. We report a case of irreversible alopecia universalis (AU) with complete hair loss extended to the whole body, which started after discontinuation of Peg-IFN/RBV combination therapy for chronic HCV infection. In conclusion, this case represents an uncommon presentation of a common disease. Physicians must be aware of the potential adverse reactions of an antiviral therapy containing IFN, which might occur even after the discontinuation, and fully inform the patient at the beginning of his treatment course. We hope that interferon-free regimens will utterly supplant interferon-based therapy for most or all HCV patients avoiding the emergence of autoimmune manifestations.

• Authors: Nesrine Gamal, Lucia Brodosi, Cosimo Misciali, Annalisa Patrizi, Gentiana Vukatana, Nazzarena Malavolta, Mauro Bernardi, Pietro Andreone
• Journal: Annals of hepatology (Ann Hepatol) 2014 Mar-Apr Vol. 13 Issue 2 Pg. 293-6 ISSN: 1665-2681 [Print] Mexico
• PMID: 24558223 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• peginterferon alfa-2b

Topics

• Alopecia (diagnosis, etiology)
• Antiviral Agents (adverse effects, therapeutic use)
• Biopsy
• Drug Therapy, Combination
• Hepatitis C, Chronic (drug therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects, therapeutic use)
• Male
• Middle Aged
• Polyethylene Glycols (adverse effects, therapeutic use)
• Recombinant Proteins (adverse effects, therapeutic use)
• Ribavirin (therapeutic use)
• Scalp (pathology)
• Treatment Outcome
• Withholding Treatment