Antiviral therapy in hemodialyzed HCV patients: efficacy, tolerance and treatment strategy

International audience; Background: In end-stage renal disease (ESRD) patients, HCV eradication improves patient and graft survival. Aim: Determine optimal use of erythropoietin and ribavirin, compare ribavirin concentrations with those of HCV patients having normal renal function and evaluate SVR in a prospective observatory of ESRD candidates for renal transplantation. Methods: Thirty-two naïve patients were treated with Peg-IFN-α2a and ribavirin. Two different schedules of ribavirin and EPO administration were used: starting ribavirin at 600 mg per week and adapting EPO when hemoglobin fell below 10 g/dL (adaptive strategy), or starting ribavirin at 1,000 mg per week while increasing EPO from the start of treatment (preventive strategy). Results: Patients treated with the adaptive strategy had lower median hemoglobin levels (9.6 vs. 10.9 g/dL, p=0.02) and more frequently median Hb levels below 10 g/dL (58 vs. 5%, p=0.0007) despite lower median ribavirin doses (105 vs. 142 mg/day, p