Fatal cardiomyopathy associated with pegylated interferon/ribavirin in a patient with chronic hepatitis C

Eur J Gastroenterol Hepatol. 2006 Mar;18(3):287-9. doi: 10.1097/00042737-200603000-00010.


We report the case of a 45-year-old man with HCV treated with pegylated interferon-alpha/ribavirin, in whom fatal cardiomyopathy occurred. Cardiomyopathy is a rare complication of high dose of standard interferon but has never been reported with pegylated interferon. The relationship between pegylated interferon-alpha/ribavirin and the development of cardiomyopathy is highly probable for the following reasons: (1) a cardiologist consultation with specific investigations had been performed before treatment excluding a pre-existing cardiomyopathy; (2) symptoms of advanced dilated cardiomyopathy appeared immediately after the end of treatment; (3) other causes of cardiomyopathy have been ruled out. In all except one of the 21 reported cases with standard interferon, cardiomyopathy was reversible. In our patient, fatal cardiomyopathy occurred with a usual dose of pegylated interferon-alpha. Clinicians should be aware of this potential complication when evaluating the ratio benefit/risk of treatment in patients with chronic hepatitis C infection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Cardiomyopathy, Dilated / chemically induced*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Fatal Outcome
  • Hepacivirus*
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / adverse effects*
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects*
  • Recombinant Proteins
  • Ribavirin / administration & dosage
  • Ribavirin / adverse effects*


  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a