Int J Immunopathol Pharmacol. 2012 Apr-Jun;25(2):551-6. doi: 10.1177/039463201202500229.
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.
聚乙二醇干扰素（peg-IFN）和利巴韦林联合治疗丙型肝炎病毒（HCV）感染众所周知与显著的不良反应相关。有几项研究调查了 IFN 治疗期间可能涉及听觉途径，但尚未描述一种监测治疗期间潜在听觉参与的方法。本研究旨在评估接受聚乙二醇干扰素和利巴韦林联合治疗的 HCV 患者的外毛细胞（OHC）功能的可能变化。13 名成年 HCV 患者（8 名女性/5 名男性，平均年龄 52±12 岁）接受了 peg-IFN 和利巴韦林联合治疗，接受了纯音听阈测试和畸变产物耳声发射（DPOAE）测试。我们比较了治疗前（T0）、治疗 3 个月时（T3）和治疗结束时（Tend）以及治疗结束后 3 个月（Tfu）的平均听阈（PTA）和平均 DPOAE 幅度。在分析的不同时间点，听力水平没有发现显著差异。在治疗期间，3 名患者出现耳鸣，其中 2 例在治疗结束后自发缓解。与 T0（19.5±0.83）相比，T3（30±1，26）和 Tend（28.6±2.16）时 DPOAE 显著增加（两个时间点均 p<0.05），而 DPOAE 在 Tfu 时恢复到治疗前水平（19.3±1.3）。在我们的组中，没有患者报告永久性听力损伤，除了一名持续耳鸣的患者。聚乙二醇干扰素可通过细胞内途径产生 OHC 运动性增加。DPOAE 测试可作为监测 IFN 诱导的耳毒性的新方法。基于最近的文献和我们的听力结果，医生应该意识到 peg-IFN 可能产生的耳毒性作用，需要进行适当的监测，并且应该告知患者 IFN 治疗对听觉途径的潜在副作用。
