Listeria monocytogenes Meningitis in a Patient with Chronic Hepatitis C Infection, Treated by Interferon alfa and Ribavirin

Vander, Tatiana; Medvedovsky, M.; Hallevy, Chen; Golzman, G.; Herishanu, Y.

doi:10.1053/jinf.2002.1085

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…The causes of the increased risk of infections during antiviral treatment with PEG‐IFN and RBV for CHC 3,6,7 remain enigmatic. We herein report ex vivo evidence that two major cell populations of the innate immune system manifest significant functional changes in effector mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Life-threatening infections have also been described primarily in patients with cirrhosis and include infectious agents typically associated with primary immunodeficiencies. 6,7 The mechanism(s) leading to increased risk of infection during antiviral treatment remains poorly understood and appears to be independent of the commonly observed leukopenia. 5,[8][9][10] Neutropenia is the most frequent cause of dose reduction and treatment discontinuation 11 in CHC, and it is common for neutrophil count to drop to levels generally considered to expose patients to bacterial infections.…”

Section: Introductionmentioning

confidence: 99%

“…An increased risk of infections has been reported during treatment 1–3 although in most cases these have limited clinical relevance 4,5 . Life‐threatening infections have also been described primarily in patients with cirrhosis and include infectious agents typically associated with primary immunodeficiencies 6,7 . The mechanism(s) leading to increased risk of infection during antiviral treatment remains poorly understood and appears to be independent of the commonly observed leukopenia 5,8–10 .…”

Section: Introductionmentioning

confidence: 99%

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Treatment with PEG‐interferon and Ribavirin for Chronic Hepatitis C Increases Neutrophil and Monocyte Chemotaxis

Giorgini

Capsoni

Podda

et al. 2009

Annals of the New York Academy of Sciences

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The incidence of infections increases during treatment with pegylated interferon (PEG-IFN) and ribavirin (RBV) for chronic hepatitis C (CHC). Despite a reduction in neutrophil count, there is no clear relationship between infection occurrence and neutropenia. In the present study we investigated whether HCV treatment alters leukocyte function. We studied cell chemotaxis, reactive oxygen species, neutrophil phagocytosis, CR3 expression, and plasma colony stimulating factors (CSF) in 20 healthy subjects and 20 patients with CHC (10 with cirrhosis) at baseline, during antiviral treatment (at 4, 12, 24 weeks), and 12 weeks after discontinuation. Our results demonstrate that neutrophil chemotaxis and oxidative burst significantly increased during treatment and returned to baseline at the end of therapy. CR3 neutrophil expression was enhanced in baseline CHC compared to controls but did not change during antiviral treatment. Chemotaxis, oxidative burst, phagocytosis, and CSF levels did not differ significantly between patients before treatment and control subjects or among CHC cases according to the presence of cirrhosis in either cell subpopulation. In conclusion, the innate immune cell activity is enhanced in patients with CHC during antiviral treatment and returns to normal after its discontinuation thus possibly playing a role in their susceptibility to infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment with PEG‐interferon and Ribavirin for Chronic Hepatitis C Increases Neutrophil and Monocyte Chemotaxis

Giorgini

Capsoni

Podda

et al. 2009

Annals of the New York Academy of Sciences

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“…There are reports of Listeria monocytogenes [3] and pneumococcal [4] meningitis after therapy with interferon and ribavirin for hepatitis C virus (HCV) infection. We present the first reported case of cryptococcal meningitis in a noncirrhotic patient with chronic HCV infection who was undergoing treatment with pegylated (PEG)-interferon-α and ribavirin.…”

Section: Introductionmentioning

confidence: 99%

Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin

Lee

Kim

et al. 2014

Korean J Intern Med

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Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-α and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm3, 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-α and ribavirin.

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“…100 person-weeks of therapy [9]. Non-respiratory infections may be higher when using pegylated interferon [10], and one case of Listeria monocytogenes meningitis has been reported previously [11].…”

mentioning

confidence: 99%

Pneumococcal Meningitis during Antiviral Treatment with Interferon and Ribavirin in a Splenectomized Patient with Chronic Hepatitis C - Do Not Miss Vaccination before Starting Therapy

Hadem

Cornberg

Hauptmann³

et al. 2008

Z Gastroenterol

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We report on a 35-year-old man who developed pneumococcal meningitis while receiving antiviral therapy with interferon (consensus interferon, CIFN) and ribavirin for chronic hepatitis C. Antibiotic therapy was started four days after the onset of symptoms. Unfortunately, the patient developed a persisting right-sided cochlear hearing impairment. Antiviral therapy led to sustained viral response of hepatitis C. At the age of 14 years he had experienced a hemorrhagic shock after a traffic accident, received multiple blood transfusions and undergone a splenectomy. He had not received vaccination against Streptococcus pneumoniae. This case report reminds us that splenectomized patients without previous pneumococcal vaccination should receive such vaccination before immunomodulatory treatment.

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Listeria monocytogenes Meningitis in a Patient with Chronic Hepatitis C Infection, Treated by Interferon alfa and Ribavirin

Cited by 8 publications

References 14 publications

Treatment with PEG‐interferon and Ribavirin for Chronic Hepatitis C Increases Neutrophil and Monocyte Chemotaxis

Treatment with PEG‐interferon and Ribavirin for Chronic Hepatitis C Increases Neutrophil and Monocyte Chemotaxis

Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin

Pneumococcal Meningitis during Antiviral Treatment with Interferon and Ribavirin in a Splenectomized Patient with Chronic Hepatitis C - Do Not Miss Vaccination before Starting Therapy

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