Early effect of peginterferon plus ribavirin treatment on blood pressure and insulin resistance in patients with chronic hepatitis C

Adverse cardiac effects of interferon (INF) treatment have been shown previously. Some increase in the arteriel blood pressure (BP) may be expected during INF therapy. In this study we aimed to investigate the early effects of peginterferon alpha-2b plus ribavirin therapy on blood pressure and related cardiovascular risk parameters and also insulin resistance. Twenty-nine patients with chronic hepatitis C (CHC) (16 women,13 men; median age: 56.5 years) were included in the study. Twenty-four hours ambulatory blood pressure monitoring of patients was recorded at pretreatment period, after 1st week and at the end of 8th week of treatment. Lipid profile, insulin resistance (IR), body mass index (BMI), complete blood counts, transaminases were studied again in the 8th week of the study. HOMA-IR method was used for IR. Hypertensive patients continued on taking antihypertensive medicine during the study. Before the therapy, 15 patients were hypertensive and 14 were normotensive. In the analysis of all patients, the median baseline, 1st week and 8th week recordings of ABPM day time, night time, mean systolic and diastolic measurements) did not show any difference. In hypertensive patients, pretreatment, 1st week of treatment and 8th of treatment values of median systolic ((134 (119-150), 133 (104-169), 132 (109-145) mmHg, respectively; p=0.07)) and median diastolic ((78 (70-96), 79 (57-92), 79 (58-89) mmHg, respectively; p=0.25)) blood pressures were not statistically significant. At the end of 8th week of the therapy; BMI, total cholesterol, LDL, HDL, hemoglobin, white blood cell,platelet, AST and ALT were decreased significantly (p<0.05). Serum triglyceride levels increased significantly (p<0.0001) and HOMA-IR decreased non-significantly (p= 0.07). Peginterferon alpha-2b plus ribavirin therapy didn't cause an increase in blood pressure in hypertensive and normotansive chronic hepatitis C patients in the early period of treatment. This treatment also didn't cause any early changes in IR status of CHC patients.