Pegylated interferon/ribavirin-associated sudden hearing loss in a patient with chronic hepatitis C in Brazil

Abstract

Sudden hearing loss is defined as a sensorineural hearing loss, equal to or greater than 30 dB, at three or more consecutive frequencies, which takes place within 72 hours. Both peginterferon and ribavirin are well-known to be associated with significant adverse effects, but sudden hearing loss is uncommon. We report a 65-year-old male patient who developed sudden-onset hearing loss during combination therapy with pegylated interferon-alpha and ribavirin for chronic hepatitis C. Peginterferon and ribavirin may cause sudden hearing loss that may not recover after discontinuation of therapy. Immediate treatment for all possible etiologies is essential, along with targeted investigations and early referral for an Ear, Nose and Throat specialist. Physicians should be aware of the possible ototoxic effects of peginterferon and ribavirin combination therapy requiring appropriate surveillance

A Narrative Review of Pharmacologic Treatments for COVID‐19: Safety Considerations and Ototoxicity

“…Our review identified nine separate case reports of severe sudden hearing loss in patients receiving pegylated (PEG)‐IFN/ribavirin combination therapy. Of these, unilateral SNHL was far more common, occurring in eight out of the nine patients 12–19 . Three cases reported temporary hearing loss that improved with cessation of pegylated (PEG)‐IFN/ribavirin combination therapy 13,14,18 .…”

“…Three cases reported temporary hearing loss that improved with cessation of pegylated (PEG)‐IFN/ribavirin combination therapy 13,14,18 . SNHL was fully reversible in two cases (after prednisone treatment) and permanent in four cases, even after cessation of treatment 12,15–17,19,20 . Tinnitus occurred concurrently with hearing loss in one case 16 …”