1. Pegylated Interferon (Alone or With Ribavirin) for Chronic Hepatitis C in Haemodialysis Population
- Author
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María Dolores Arenas, Jesús Hernández, Fernando Carnicer, Fabrizio Fabrizi, C. Caramelo, and Mario Espinosa
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Sofosbuvir ,medicine.medical_treatment ,lcsh:RC870-923 ,medicine.disease_cause ,Gastroenterology ,Polyethylene Glycols ,Cohort Studies ,chemistry.chemical_compound ,Pegylated interferon ,Chronic kidney disease ,lcsh:Dermatology ,Medicine ,Prospective Studies ,education.field_of_study ,General Medicine ,Hepatitis C ,Middle Aged ,Recombinant Proteins ,Treatment Outcome ,Nephrology ,RNA, Viral ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Adult ,medicine.medical_specialty ,Daclatasvir ,Hepatitis C virus ,Population ,Antiviral Agents ,Renal Dialysis ,Internal medicine ,Ribavirin ,Humans ,education ,Aged ,Retrospective Studies ,business.industry ,Interferon-alpha ,Hepatitis C, Chronic ,lcsh:RL1-803 ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,chemistry ,lcsh:RC666-701 ,Immunology ,business ,Dialysis ,Follow-Up Studies - Abstract
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.
- Published
- 2015