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Gabr T, Kotait M, Moaty AS. Audiovestibular and vaccination complications of COVID-19. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC9389503 DOI: 10.1186/s43163-022-00290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Objectives
Since its first appearance in Wuhan December 2019, SARS-CoV2 virus received great attention due to its severe symptoms and high spread causing COVID-19 disease which spread all over the world like a pandemic. The causative virus is capable of human-to-human transmission via droplet and direct contact suggesting that upper respiratory tract is the main site to virus manifestations.
There is a great diversity in its clinical picture, although the severe respiratory and neurological symptoms are commonly present; however, other symptoms are present. Although otological manifestations are reported in many COVID-19 patients even in asymptomatic cases, they did not receive much attention compared with other critical manifestations. In this article, we paid our attention specifically to the otological manifestations of COVID-19 and their relevance either to the virus infection, treatment, or vaccination through literature review.
Conclusion
COVID-19 disease has a deleterious effect on the inner ear. This effect is not only due to SARS-Cov-2 infection, but it could be also due to the ototoxic drugs used for treatment. The COVID-19 vaccinations are found to be implicated in the otological symptoms in some cases.
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Little C, Cosetti MK. A Narrative Review of Pharmacologic Treatments for COVID-19: Safety Considerations and Ototoxicity. Laryngoscope 2021; 131:1626-1632. [PMID: 33491234 PMCID: PMC8014300 DOI: 10.1002/lary.29424] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE/HYPOTHESIS The purpose of this review is to summarize evidence-based data regarding the ototoxic effects of potential COVID-19 therapeutics to treat patients suffering from SARS-CoV-2. METHODS Medications under investigation as novel therapeutics to treat COVID-19 were identified using the search term coronavirus therapeutics, COVID therapeutics, and SARS-CoV-2 therapeutics on ClinicalTrials.gov and the PubMed Database. A literature review was performed using the PubMed Database for each proposed COVID-19 therapeutic to identify relevant articles. Search criteria included Medical Subject Headings (MeSH) and key word search terms for ototoxicity, vestibulotoxicity, hearing disorders, and vertigo. RESULTS Six proposed COVID-19 therapeutics were identified as possessing ototoxic side effects including chloroquine and hydroxychloroquine, azithromycin, lopinavir-ritonavir, interferon, ribavirin, and ivermectin. CONCLUSIONS Available evidence suggests that ototoxic effects may be improved or mitigated by stopping the offending agent. Recognition of hearing loss, tinnitus, or imbalance/vertigo is therefore crucial to facilitate early intervention and prevent long-term damage. Hospitals should consider the inclusion of audiologic monitoring protocols for patients receiving COVID-19 therapeutics with known ototoxicity, especially in high-risk patient groups such as the elderly and hearing impaired. Laryngoscope, 131:1626-1632, 2021.
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Affiliation(s)
- Christine Little
- Department of Otolaryngology‐Head and Neck SurgeryIcahn School of Medicine at Mount SinaiNew YorkNew YorkU.S.A.
| | - Maura K. Cosetti
- Department of Otolaryngology‐Head and Neck SurgeryIcahn School of Medicine at Mount SinaiNew YorkNew YorkU.S.A.
- Ear InstituteNew York Eye and Ear Infirmary of Mount SinaiNew YorkNew YorkU.S.A.
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Visual and brainstem auditory evoked potentials in HCV-infected patients before and after interferon-free therapy - A pilot study. Int J Infect Dis 2019; 80:122-128. [PMID: 30641198 DOI: 10.1016/j.ijid.2019.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/02/2019] [Accepted: 01/04/2019] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The aim of this study was to investigate brain bioelectrical activity disturbances in HCV-positive patients before and 24 weeks after interferon-free therapy (DAA), using visual (VEP) and brainstem (BAEP) evoked potentials and advanced magnetic resonance techniques. MATERIALS AND METHODS 11 HCV-infected patients (6 women, 5 men, mean age 51 years old) and 30 healthy controls, sex and age-matched, were studied. Clinical neurological examinations, VEP, BAEP, diffusion tensor imaging (DTI) and perfusion weighted imaging (PWI) were performed. RESULTS 11 patients achieved a sustained viral response, and liver fibrosis regression in APRI and in elastography were observed. The mean P100 latency was significantly shorter in HCV-patients after therapy compared to the values before treatment (p<0.05). The mean wave BAEP V latency and I-V interpeak latency were significantly longer in the HCV-infected patients before therapy compared to HCV-patients after therapy. CONCLUSIONS This study confirms that treatment with DAA in patients with chronic HCV infection positively affects the bioelectrical activity of the brain. An increase in the amplitude of EP after treatment indicates an improvement in the activity of the cerebral cortex. EP examination may be a useful method of assessing the function of the nervous system before and after antiviral treatment.
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Zittoon RF, Madian YT, Alhennawi DEM, Nadeem HS. Cochlear Changes Caused by Peginterferon α-2b. J Interferon Cytokine Res 2018; 38:311-316. [PMID: 30016180 DOI: 10.1089/jir.2018.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
To evaluate the effect of peginterferon α-2b on guinea pigs' hearing and its cochlea, and to determine whether these effects are permanent or reversible. This study is an experimental animal study done on the organs of Corti of 30 guinea pigs after a peginterferon α-2b injection course. The cochleae of guinea pigs were extracted and examined by scanning electron microscopy for the right side and immunohistochemistry for the left side. All guinea pigs were subjected to pinna reflex, otological examination, and distortion product otoacoustic emission (DPOAE) both before and after the receiving of interferon (IFN). Electron microscopic scanning and immunohistochemistry of the cochleae revealed that peginterferon α-2b has a harmful effect on guinea pigs' cochleae, in the form of structural changes in the hair cells and supporting cells with apoptotic changes in the organ of Corti and the stria vascularis. These changes were reversible. DPOAE showed a significant reduction in distortion product mean amplitude and signal-to-noise ratio in all frequencies after 3 days from the last dose of IFN injection except at 1,006 Hz. After 14 days, there was a significant improvement in most of the frequencies, but are still below the normal values.
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Affiliation(s)
- Reham F Zittoon
- 1 Department of Otorhinolaryngology, Faculty of Medicine, Suez Canal University , Ismailia, Egypt
| | - Yasser T Madian
- 1 Department of Otorhinolaryngology, Faculty of Medicine, Suez Canal University , Ismailia, Egypt
| | - Diaa Eldeen M Alhennawi
- 1 Department of Otorhinolaryngology, Faculty of Medicine, Suez Canal University , Ismailia, Egypt
| | - Hany S Nadeem
- 2 Department of Anatomy, Faculty of Medicine, Ain Shams University , Cairo, Egypt
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Chin-Loy K, Galaydh F, Shaikh S. Retinopathy and Uveitis Associated with Sofosbuvir Therapy for Chronic Hepatitis C Infection. Cureus 2016; 8:e597. [PMID: 27335709 PMCID: PMC4895080 DOI: 10.7759/cureus.597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: We report a case of retinopathy and uveitis associated with sofosbuvir therapy for hepatitis C infection. Methods: Case report. Results: A 57-year-old-male developed ocular inflammation and retinopathy four weeks after the administration of sofosbuvir for a hepatitis C infection. Hearing loss, rheumatologic disease, and essential tremor were also noted. The ophthalmic findings resolved with discontinuation of the drug. Conclusion: The authors report a case of sofosbuvir induced retinopathy and uveitis, the first associated with this emerging therapy for hepatitis C. Ophthalmologists and other treating physicians should be aware of the ophthalmic side effects of this drug.
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Affiliation(s)
| | - Farah Galaydh
- Ophthalmology, Orlando Veterans Affairs Medical Center
| | - Saad Shaikh
- Ophthalmology, UCF College of Medicine ; Ophthalmology, USF College of Medicine ; Ophthalmology, Howard University College of Medicine ; Ophthalmology, University of Texas Medical Branch at Galveston ; Ophthalmology, Orlando Veterans Affairs Medical Center ; Ophthalmology, Florida State University College of Medicine
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Mayet AY. Loss of smell (anosmia) and taste (ageusia) in a patient treated with pegylated interferon alfa and ribavirin. CURRENT THERAPEUTIC RESEARCH 2014; 68:271-7. [PMID: 24683217 DOI: 10.1016/j.curtheres.2007.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/29/2007] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Anosmia, the loss of the sense of smell, is a rare adverse event associated with interferon alpha (INF-α). Millions of patients with hepatitis B and hepatitis C virus (HCV) infection are currently treated with INF-alfa-2a daily. Only 5 cases of anosmia have been reported in the literature, and none was associated with pegylated INF-alfa. CASE SUMMARY A 55-year-old Arab male (height, 5'1″; weight, 81 kg) with chronic HCV developed anosmia and ageusia (loss of the sense of taste) after 36 weeks of treatment for HCV with subcutaneous pegylated INF-alfa-2a 180 μg and ribavirin 1200 mg. Treatment was continued for 12 additional weeks before being discontinued. Twenty-four weeks after treatment was discontinued, HCV-RNA was undetectable and, during the same visit, the patient reported that he had regained his sense of smell a few weeks previously. The Naranjo algorithm score was 7, representing a probable association of anosmia with INF-alfa-2a treatment. Other etiologies for loss of smell and taste were ruled out. CONCLUSIONS We report a case of anosmia and ageusia in a patient treated with pegylated INF-alfa-2b and ribavirin for HCV infection. The patient regained his sense of smell and taste within 24 weeks of stopping treatment.
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Affiliation(s)
- Ahmed Yacoob Mayet
- Gastroenterology Department, King Khafid University Hospital, Riyadh, Saudi Arabia
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Casale M, Mazzarelli C, Vespasiani Gentilucci U, Potena M, Pappacena M, Faiella F, Galati G, Salvinelli F, Picardi A. Distortion-product otoacoustic emissions: a useful test for monitoring ototoxicity induced by pegylated interferon and ribavirin treatment in patients with chronic hepatitis C. Int J Immunopathol Pharmacol 2012; 25:551-6. [PMID: 22697091 DOI: 10.1177/039463201202500229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pegylated-interferon (peg-IFN) and ribavirin combination therapy for the treatment of hepatitis C virus (HCV) infection is well known to be associated with significant adverse effects. Several studies have investigated a possible auditory pathway involvement during IFN therapy, but a method to monitor the potential auditory involvement during treatment has not yet been described. The aim of this study is to evaluate possible modifications of the outer hair cell (OHC) function in HCV patients receiving peg-IFN and ribavirin combination therapy. Thirteen adult HCV patients (8 F/5 M, mean age 52∓12 years) treated with peg-IFN and ribavirin combination therapy underwent Pure Tone Audiogram and Distortion Product Otoacoustic Emission (DPOAE) tests. We compared mean auditory thresholds (PTA) and mean DPOAE amplitude before, at month 3 during, and at the end of treatment (T0, T3, and Tend, respectively), and 3 months after treatment discontinuation (Tfu). No significant differences were found in hearing levels at the different time points analyzed. During treatment, three patients developed tinnitus, which in 2 cases resolved spontaneously after the end of therapy. Compared to T0 (19.5±0.83), a statistically significant DPOAE increase at T3 (30±1,26) and Tend (28.6±2.16) was found (p<0.05 at both time points), while DPOAEs returned to pre-treatment levels at Tfu (19.3±1.3). In our group, none of the patients reported a permanent auditory impairment, excluding one patient with persistent tinnitus. Peg-IFN could produce an increase of motility of the OHCs by means of intracellular pathways. DPOAE test could be considered a new method for monitoring ototoxicity induced by IFN. On the basis of recent literature and our audiological results, physicians should be aware of the possible ototoxic effects of peg-IFN, requiring appropriate surveillance, and the patient should be informed of the potential side effects of IFN therapy on the auditory pathway.
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MESH Headings
- Acoustic Stimulation
- Adult
- Antiviral Agents/adverse effects
- Audiometry, Pure-Tone
- Auditory Threshold/drug effects
- Drug Therapy, Combination
- Female
- Hair Cells, Auditory, Outer/drug effects
- Hair Cells, Auditory, Outer/pathology
- Hearing Disorders/chemically induced
- Hearing Disorders/diagnosis
- Hearing Disorders/physiopathology
- Hearing Loss, Sensorineural/chemically induced
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/physiopathology
- Hepatitis C, Chronic/drug therapy
- Humans
- Interferon alpha-2
- Interferon-alpha/adverse effects
- Male
- Middle Aged
- Otoacoustic Emissions, Spontaneous/drug effects
- Polyethylene Glycols/adverse effects
- Predictive Value of Tests
- Recombinant Proteins/adverse effects
- Ribavirin/adverse effects
- Rome
- Time Factors
- Tinnitus/chemically induced
- Tinnitus/diagnosis
- Tinnitus/physiopathology
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Jain S, Midha V, Sood A. Unilateral hearing loss due to pegylated interferon-α2b and ribavirin therapy. Indian J Gastroenterol 2011; 30:239-40. [PMID: 21986854 DOI: 10.1007/s12664-011-0126-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Eser Karlidag G, Karlidag T, Demirdag K, Keles E. The effects of pegylated interferon/lamivudine therapy on auditory functions in patients with chronic hepatitis B. Auris Nasus Larynx 2011; 38:312-8. [PMID: 21216118 DOI: 10.1016/j.anl.2010.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 09/28/2010] [Accepted: 10/01/2010] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study was to assess the effects of pegylated interferon monotherapy and pegylated interferon+lamivudine combination therapy on auditory functions in patients with chronic hepatitis B (CHB) infection. METHODS A total of 54 patients with a diagnosis of CHB were grouped into four treatment groups: patients in Group 1 received pegylated interferon-alpha 2a; patients in Group 2 received pegylated interferon-alpha 2a+lamivudine; patients in Group 3 received pegylated interferon-alpha 2b, and patients in Group 4 received pegylated interferon-alpha 2b+lamivudine treatment. The auditory system (using standard and high frequency audiometry) and the vestibulocochlear adverse effects including otalgia, tinnitus, vertigo and imbalance were assessed immediately before the onset of the study, and at the 12th, 24th, and 48th weeks of the study. RESULTS A mean elevation of auditory threshold of 1-10dB was found in all treatment groups when the thresholds at the onset of the study and the thresholds at the 12th, 24th, and 48th weeks were compared. However, the elevations were not significant. The elevations were mostly at high frequencies (10,000, 12,000 and 16,000Hz). The most common vestibulocochlear adverse effects related to treatment were tinnitus, vertigo, imbalance, and otalgia, respectively. Tinnitus was the most common adverse effect in Group 2, vertigo was the most common in Group 3, imbalance was at equal frequency in Group 2 and 3, and otalgia was the most common adverse effect in Group 2 (p>0.05). CONCLUSION There were no significant auditory adverse effects in the treatment groups. We think that it may be beneficial to monitor the auditory functions in patients receiving PEG-IFN treatment because of the mild elevation in the auditory thresholds (although not significant).
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Affiliation(s)
- Gulden Eser Karlidag
- Elazig Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Elazig, Turkey
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Hagr A, Jamjoom D, Sanai FM, Al Hamoudi W, Abdo AA, Al-Arfaj A. Effect of interferon treatment on hearing of patients with chronic hepatitis C. Saudi J Gastroenterol 2011; 17:114-8. [PMID: 21372348 PMCID: PMC3099056 DOI: 10.4103/1319-3767.77240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/AIM Some reports in the literature have linked interferon therapy for the treatment of hepatitis C (HCV) with hearing loss. The aim of this study has been to examine the effects of interferon therapy on hearing of patients treated for HCV. PATIENTS AND METHODS Patients were recruited according to preset inclusion criteria from two centers. All patients received standard dose pegylated interferon (PEG-IFN a-2b or a-2a) plus ribavirin (RBV). All patients had pure-tone audiometry (PTA), tympanogram and distortion-product otoacoustic emission (DPOAE) before treatment, three months after initiation of treatment, and three months after completion of treatment. RESULTS Twenty one patients were prospectively recruited. The mean age was 45.7 years. The male to female ratio was 1.1:1. The mean PTA was 15.9 ± 5.3 before treatment, 17.4 ± 6.1 during treatment and 16.5 ± 5.1 after treatment. The differences between pre and mid, pre and post, as well as mid and post were not significantly different (P>0.05) in all audiological assessments. CONCLUSIONS Our results indicate that PEG-IFN\RBV therapy does not have any impact on the hearing thresholds of patients with HCV.
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Affiliation(s)
- Abdulrahman Hagr
- Department of ENT, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Dima Jamjoom
- Department of ENT, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Faisal M. Sanai
- Department of Medicine, Division of Gastroenterology & Hepatology, Riyadh Military Hospital, Riyadh, Saudi Arabia
| | - Waleed Al Hamoudi
- Gastroenterology Division, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman A. Abdo
- Gastroenterology Division, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Al-Arfaj
- Department of ENT, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Ahmed Al-Arfaj, Department of Otolaryngology, College of Medicine, King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia. E-mail:
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Pérez-Berná AJ, Pabst G, Laggner P, Villalaín J. Biophysical characterization of the fusogenic region of HCV envelope glycoprotein E1. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2009; 1788:2183-93. [PMID: 19698697 DOI: 10.1016/j.bbamem.2009.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Revised: 07/27/2009] [Accepted: 08/04/2009] [Indexed: 01/08/2023]
Abstract
We have studied the binding and interaction of the peptide E1(FP) with various model membranes. E1(FP) is derived from the amino acid segment 274-291 of the hepatitis C virus envelope glycoprotein E1, which was previously proposed to host the peptide responsible for fusion to target membranes. In the present study we addressed the changes which take place upon E1(FP) binding in both the peptide and the phospholipid bilayer, respectively, through a series of complementary experiments. We show that peptide E1(FP) binds to and interacts with phospholipid model membranes, modulates the polymorphic phase behavior of membrane phospholipids, is localized in a shallow position in the membrane and interacts preferentially with cholesterol. The capability of modifying the biophysical properties of model membranes supports its role in HCV-mediated membrane fusion and suggests that the mechanism of membrane fusion elicited by class I and II fusion proteins might be similar.
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Affiliation(s)
- Ana J Pérez-Berná
- Instituto de Biología Molecular y Celular, Universidad Miguel Hernández, E-03202 Alicante, Spain
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Piekarska A, Jozefowicz-Korczynska M, Wojcik K, Berkan E. Sudden hearing loss in chronic hepatitis C patient suffering from Turner syndrome, treated with pegylated interferon and ribavirin. Int J Audiol 2009; 46:345-50. [PMID: 17680465 DOI: 10.1080/14992020701261413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sudden hearing loss is a very rare complication of interferon-alpha treatment. At this time, hearing loss in patients treated with pegylated interferon and ribavirin has only been described in two reports. We present a case of a 27-year-old patient who was diagnosed with Turner syndrome, treated for hepatitis C with pegylated interferon and ribavirin, and suffered from hearing loss during the 10th week of treatment. Audiometric examination revealed a bilateral sensorineural hearing loss (SNHL). Auditory brainstem response (ABR) measures confirmed the diagnosis. We decided to comply with the patient's request to continue therapy, which only led to slight further deterioration of the patient's hearing ability. However, 18 months after the end of therapy a follow-up audiometric examination disclosed a bilateral SNHL.
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Affiliation(s)
- Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Lodz, Poland.
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Le V, Bader T, Fazili J. A case of hearing loss associated with pegylated interferon and ribavirin treatment ameliorated by prednisone. ACTA ACUST UNITED AC 2008; 6:57-60. [DOI: 10.1038/ncpgasthep1317] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Accepted: 10/24/2008] [Indexed: 12/30/2022]
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Elloumi H, Houissa F, Hadj NB, Gargouri D, Romani M, Kharrat J, Ghorbel A. Sudden hearing loss associated with peginterferon and ribavirin combination therapy during hepatitis C treatment. World J Gastroenterol 2007; 13:5411-2. [PMID: 17879419 PMCID: PMC4171339 DOI: 10.3748/wjg.v13.i40.5411] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adverse effects associated with peginterferon and ribavirin during hepatitis C treatment are well known. Sudden hearing loss has rarely been reported. Possible mechanisms involved include direct ototoxicity of interferon, autoimmunity, and hematological changes. Hearing loss is frequently fully resolved after discontinuation of antiviral therapy. We report a 47-year-old man with chronic hepatitis C, genotype 2 ac who developed sudden hearing loss 22 wk after starting therapy with peginterferon alpha 2a at a dose of 180 μg per week and ribavirin 800 mg per day. Since symptoms did not worsen, antiviral therapy was continued for 2 wk, according to the patient's wish. Hearing loss resolved within 2 wk after the end of treatment. Serum liver alanine aminotransferase remained normal during and after the end of antiviral therapy. HCV RNA was undetectable at the end of therapy and remained negative 24 wk later. Thus, patients should be aware that hearing loss may occur with peginterferon therapy, but the decision whether to continue or to stop the treatment is based on the clinical judgment of the physician and the wishes of the patient.
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Affiliation(s)
- Hela Elloumi
- Department of Gastroenterology and Hepatology, Habib Thameur Hospital, Tunis, Tunisia.
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