45 have reported irreversible

cases of pulmonary hypertension induced by IFN therapy in HCV-infected patients. The next section presents an in-depth discussion on such cases. Microvascular Injury to the Heart, Kidneys, and Retina after Interferon (IFN) Therapy It has been demonstrated that IFN can aggregate leukocytes within the capillaries, resulting in vascular damage and micro-infarctions. This can affect a number of organs, particularly the heart and eyes. In a mouse model, Salman et al.46 have reported that IFN-alpha-2b therapy in mice could lead to a significant increase in the thickness of the endothelial processes of the myocardial capillary walls, with a subsequent decrease in Inhibitors,research,lifescience,medical the size of the capillary lumen. This might explain the augmented rate of cardiomyopathies, especially dilated cardiomyopathy, in HCV-infected patients who undergo IFN therapy. Cardiomyopathy is not the only IFN-induced complication as an adverse effect for IFN therapy in HCV-infected patients. Retinopathy is one of the most frequently reported microvascular Inhibitors,research,lifescience,medical complications of IFN in HCV-infected individuals. Both arterial and venous origins have been proposed as culprits. In

some cases, the retinopathy is irreversible. In a prospective cohort of 63 patients with chronic HCV infection Inhibitors,research,lifescience,medical and no retinal lesions before IFN-alpha therapy, Kawano et al.47 reported that over 57% of the patients developed MLN8237 retinopathies,

including 25 (40%) cases of retinal hemorrhage and 28 (44%) cases of cotton wool spots. Interestingly, 86% of the lesions were diagnosed Inhibitors,research,lifescience,medical within 8 weeks after onset of IFN administration. In a similar study by Sugano et al.,48 24% of the HCV-infected patients who started IFN therapy developed retinal hemorrhage, with two-thirds of them developing cotton wool spots and half Inhibitors,research,lifescience,medical having visual symptoms. Consistent with the previous study, approximately 85% of the patients developed their retinal signs just within the first 8 weeks post-IFN administration. In a larger recently published study, Vujosevic et al.49 demonstrated that 31% of the HCV-infected patients undergoing PEG-IFN and Ribavirin developed retinopathy. Hypertension was defined as the only independent factor associated with IFN-induced retinopathy [hazard ratio (HR)=4.99, 95% confidence interval (CI): 2.29-10.89]. Only one (1.1%) Edoxaban patient needed therapy cessation due to bilateral branch retinal vein occlusion. The authors conducted a cost-effective study and showed that screening for PEG-IFN induced retinopathy was cost-effective. Pulmonary Injury due to Interferon (IFN) Therapy in HCV Infection Pulmonary dysfunction due to IFN therapy in HCV-infected individuals has been reported. Garib et al.50 reported dyspnea after PEG-IFN therapy in HCV patients with advanced liver disease. Spirometric changes in FEV1 and FEV1/FVC were also observed. Kumar et al.