Investigation of hyperuricemia during pegylated-interferon-α2b plus ribavirin combination therapy in patients with chronic hepatitis C

OBJECTIVE: Hyperuricemia has been reported as being an adverse effect of pegylated-interferon-alpha 2b (Peg-IFN alpha 2b) and ribavirin combination therapy for chronic hepatitis C and hyperuricemic changes occur in some patients during the therapy. However, detailed investigation of the elevation of uric acid has not been carried out previously. The incidence and mechanism of hyperuricemia were investigated in this study. METHODS: The data of 50 patients with chronic hepatitis C who had been treated with Peg-IFN alpha 2b and ribavirin combination therapy or pegylated-interferon-alpha 2a monotherapy for more than 24 weeks were analyzed. The effects of these treatments were evaluated clinically by the serum uric acid level and its urinary excretion rates. RESULTS: In patients with pegylated-interferon-alpha 2a monotherapy, no significant elevation was shown either in serum uric acid concentrations or excretion rates. On the other hand, serum uric acid concentrations were significantly elevated during the combination therapy, reaching >= 7.0 mg/L in men and >= 6.5 mg/L in women in 15% of patients. The urinary uric acid excretion rate was also elevated significantly. CONCLUSION: Peg-IFN alpha 2b plus ribavirin combination therapy induced an elevation of uric acid concentration, although the elevated levels were still within normal limit in many cases. It may be that ribavirin plays a leading role in its elevation and other factors may also be involved.