Dermatological side effects of hepatitis C and its treatment: patient management in the era of direct-acting antivirals.

摘要: Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV leads to dermatological muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome. Peginterferon/ribavirin treatment is associated with well-characterized AEs tending towards a uniform entity dermatitis. New direct-acting antivirals have led significant improvements in sustained virologic response rates, but several increase versus alone. In telaprevir trials, approximately half treated patients had rash. More than 90% these were Grade 1 or 2 (mild/moderate) majority (92%) cases, progression more severe grade did not occur. small number cases (6%), rash discontinuation, whereupon symptoms commonly resolved. telaprevir-based triple therapy generally similar those observed (xerosis, pruritus, eczema). A few classified cutaneous reaction (SCAR), also referred serious skin reactions, group rare conditions that potentially life-threatening. It therefore important distinguish between telaprevir-related dermatitis SCAR. The prescribing information does require discontinuation for rash, which can be using emollients/moisturizers topical corticosteroids. For 3 mandates immediate ribavirin interruption (with without peginterferon) within 7 days stopping if there no improvement, sooner it worsens. case suspicion confirmed diagnosis SCAR, all study medication must discontinued.