Dear Editor:
I have a 45 YO white female
with hep C 2a who, post-9 weeks of treatment developed acute pancreatitis. Her viral load had been <3200 since the 4th
week. If she should relapse, should we retreat?
If so, what should I use and should the dose be lowered and to what?
GS
Dear GS:
I presume that this patient
had no alternative potential causes of acute pancreatitis, such as alcohol
abuse, gallstones, cancer, hypertriglyceridemia, other drugs known to induce
pancreatitis, etc. Acute pancreatitis has been associated with both
peginterferon and ribavirin. Thus, retreatment would most certainly put your
patient at risk for a second episode of drug-induced pancreatitis. I would be
inclined to follow this patient and await newer developments in therapy,
especially if you know that the stage of fibrosis is 0-2 and not advanced.