Seizures in patients with chronic hepatitis C treated with NS3/4A protease inhibitors: does pharmacological interaction play a role?

Pharmacology. 2013;92(5-6):235-7. doi: 10.1159/000355836. Epub 2013 Oct 31.

Abstract

The addition of NS3/4A protease inhibitors boceprevir and telaprevir to pegylated interferon (Peg-IFN)-α and ribavirin for the treatment of hepatitis C virus (HCV) genotype 1-infected patients has led to higher rates of virological response and adverse events. Among the several side effects of interferon, neuropsychiatric symptoms have been described, particularly depression and anxiety, occurring in about 25% of patients. Although seizures have been reported in interferon-treated patients with multiple sclerosis and in a variety of malignancies, the epileptogenic potential of interferon-α in the treatment of HCV infection is considered minimal. In this report we present a new onset of seizures occurring in 2 patients during anti-HCV therapy in association with Peg-IFN, ribavirin and HCV protease inhibitors.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Carrier Proteins / antagonists & inhibitors
  • Drug Interactions
  • Follow-Up Studies
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / adverse effects
  • Intracellular Signaling Peptides and Proteins
  • Male
  • Middle Aged
  • Oligopeptides / administration & dosage
  • Oligopeptides / adverse effects
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects
  • Proline / administration & dosage
  • Proline / adverse effects
  • Proline / analogs & derivatives
  • Protease Inhibitors / administration & dosage
  • Protease Inhibitors / adverse effects*
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Ribavirin / administration & dosage
  • Ribavirin / adverse effects
  • Seizures / chemically induced*
  • Viral Nonstructural Proteins / antagonists & inhibitors

Substances

  • Antiviral Agents
  • Carrier Proteins
  • Interferon alpha-2
  • Interferon-alpha
  • Intracellular Signaling Peptides and Proteins
  • NS3 protein, hepatitis C virus
  • NS4A cofactor peptide, Hepatitis C virus
  • Oligopeptides
  • Protease Inhibitors
  • Recombinant Proteins
  • Viral Nonstructural Proteins
  • Polyethylene Glycols
  • Ribavirin
  • telaprevir
  • N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
  • Proline
  • peginterferon alfa-2b
  • peginterferon alfa-2a