Pegylated Interferon (Alone or With Ribavirin) for Chronic Hepatitis C in Haemodialysis Population

Kidney and Blood Pressure Research

Arenas M.D.⁴  Fabrizi F.³  Caramelo C.¹  Carnicer F.¹  Espinosa M.²  Hernàndez J.¹ 

[1] Division of Nephrology, Reina Sofia University Hospital, Cordoba; $$;Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Milano, Italy$$;Division of Nephrology, Perpetuo Socorro Hospital; $$

关键词: Chronic kidney disease;    Dialysis;    Hepatitis C;    Pegylated interferon;    Ribavirin;   

DOI  :  10.1159/000368501

来源: S Karger AG

【 摘 要 】

Background/Aims: Hepatitis C virus infection remains prevalent among patients undergoing long-term haemodialysis and has a detrimental impact on survival in this population. Antiviral therapy for chronic hepatitis C in haemodialysis patients is still a challenge to clinicians. The aim of the current study is to evaluate the efficacy and safety of therapy with pegylated interferon, alone or combined with ribavirin, for chronic hepatitis C among patients undergoing long-term hemodialysis. Methods: We conducted a retrospective, multicenter cohort trial with monotherapy (pegylated interferon) (n=21) or combined antiviral therapy (pegylated interferon plus ribavirin) (n=5) for chronic hepatitis C in patients undergoing long-term haemodialysis. Results: Sustained virological response was obtained in eleven (42%) patients. Seven (26.9%) patients interrupted prematurely the antiviral treatment due to serious side-effects, the most frequent cause of treatment withdrawal being hematological (n=3). HCV RNA load was lower in responder than non-responder patients, 5.44 (3.45; 6.36) vs. 5.86 (4.61; 6.46) log₁₀ copies/mL, even if the difference was not significant (P=0.099). Blood transfusion requirement was greater in patients on combined antiviral therapy than those on pegylated interferon alone, 100% (5/5) vs. 0% (0/21), P=0.0001. No difference in sustained viral response occurred between patients on combined antiviral therapy and those on pegylated interferon monotherapy [40% (2/5) vs. 42.8% (9/21), P=0.90]. Conclusions: Results from this study showed that pegylated interferon alone or with ribavirin is unsatisfactory in terms of efficacy and safety. Prospective trials based on interferon-free regimens (i.e., sofosbuvir plus ribavirin or sofosbuvir plus daclatasvir) are under way in patients with hepatitis C receiving long-term hemodialysis.

【 授权许可】

Unknown