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

Autor: María Dolores Arenas, Jesús Hernández, Fernando Carnicer, Fabrizio Fabrizi, C. Caramelo, Mario Espinosa
Rok vydání: 2015
Předmět:
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
Zdroj: Kidney & Blood Pressure Research, Vol 40, Iss 3, Pp 258-265 (2015)
ISSN: 1423-0143
1420-4096
DOI: 10.1159/000368501
Popis: 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.
Databáze: OpenAIRE
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