Session:

Virology and Viral Infections (Non-HIV)

Abstract No.:

40.032

Title:

Retinopathy and the association with pegylated interferon and Ribavirin

Author(s):

J. Farley, A. Truong, T. Nguyen, W. Shum; Dr John Farley Inc, Dr John Farley Inc, Vancouver, BC/CA

Abstract:

Background: Treatment of hepatitis C (HCV) with Pegylated interferon and Ribavirin can result in a many adverse effects but ocular complications are considered rare, benign and usually reversible which does not require the cessation of treatment regimen.  It has been suggested that retinopathy in patients undergoing treatment with Pegylated interferon are increase if a history of hypertension is present.  However, retinopathy can occur without history of hypertension.
Methods: Retrospective chart review of 4 individuals who developed retinal complications during hepatitis C treatment with Pegylated Interferon Alfa 2a and Ribavirin. 
Results: 4 Males, average age 49.75±5.97 years. Ethnicities: 2 Caucasian, 1 Vietnamese, 1 Aboriginal.  We assessed for other co-morbidities such as diabetes (1 was uncertain); hypertension, and hypercholestrol were not a factor. 2 was genotype 2, 1 genotype 3, and 1 genotype 1. Rapid viral response with HCV RNA undetected at week 4 was noted for 3 with genotype 2 or 3, and early viral response with HCV RNA undetected at week 12 was noted for 1 who had genotype 1. Fibrosis: 1 No Fibrosis, 1 Fibrosis Stage 2, 1 Fibrosis Stage 3, and 1 did not complete a biopsy. Averages wait time from likely infected date to treatment 20 years. Average wait time from year diagnosed was 6.67 years. 2 likely acquired through intravenous drug use and 2 were uncertain who they acquired HCV. Retinal complications occurred between weeks 14 and 26 of treatment with average time of 21 weeks into treatment. Diagnoses entertained included  blurry vision in both eyes to retinal hemorrhage and atherosclerotic retinopathy. 
Conclusion: Retinopathy in patients treated with Pegylated Interferon Alfa 2a and Ribavirin is considered rare. However, routine follow up is essential for management on treatment. We speculate that individuals with more severe disease may be more likely to develop retinopathy. More research should be completed in order to evaluate this aspect. Multidisciplinary management during the course of treatment is essential towards identifying and monitoring for side effects and treatment response.