Efficacy of Interferon-α in the Treatment of Chronic Hepatitis C in Dialysis Patients: Two Therapeutic Protocols Compared

Abstract

Background: Data on the efficacy of particular therapeutic protocols of interferon-α (IFN-α) treatment for chronic hepatitis C in patients on hemodialysis (HD) vary. Aim: To compare the efficacy of two different therapeutic protocols for HD patients. Patients and Methods: 15 hepatitis C virus (HCV)-positive patients on chronic HD at two dialysis centers: 8 patients treated with IFN-α 3 × 3 MU/week s.c. for 6 months (group A), and 7 patients treated with IFN-α 3 × 5 MU/week for 3 months, then 1 × 5 MU/week for another 3 months (group B). End of treatment response (ETR) and sustained virologic response (SVR) were evaluated by HCV-RNA determination. There was no statistically significant difference between the two patient groups according to age, sex, duration of HD and HCV infection. Results: ETR was 87.5% (7/8) in group A and 28.5% (2/7) in group B, being statistically significant (p < 0.05). Although better SVR [50% (4/8) vs. 28.5% (2/7)] and lower drop-out rate [0% (0/8) vs. 28.5% (2/7)] were achieved in group A compared to group B, these differences did not reach statistical significance (p > 0.05). Conclusion: Therapy with IFN-α 3 × 3 MU/week s.c. for 6 months seems to be more appropriate for treatment of hepatitis C in HD patients, mostly due to better tolerability, i.e. lower drop-out rate. These differences could be attributed to different pharmacokinetic properties of the particular therapy protocol.

Response Guided Treatment with Telaprevir or Boceprevir in End Stage Renal Disease Patients with Hepatitis C Genotype 1

“…Interferon monotherapy had a significant range with respect to SVR from 20-71% but was complicated by high dropout rates due to medication-induced side effects [21][22][23] . The use of combination pegylated-interferon and ribavirin demonstrated better SVR rates than previously noted with interferon monotherapy.…”

Hepatitis C virus and kidney disease

“…Monotherapy with standard IFN in HCV-infected patients on maintenance hemodialysis has been evaluated in numerous albeit generally small clinical trials [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] [ Table 2], only a few of which were controlled [66,69,73]. A recent meta-analysis identified 24 trials (529 unique patients) demonstrating that the summary estimate of the sustained virological response (SVR) was 39% (95% CI, 32; 46), and 33% (95% CI, 19; 47) for genotype 1 [80].…”

Treatment of chronic hepatitis C in hemodialysis patients

“…Most studies investigating the use of conventional IFN alfa monotherapy in patients with chronic hepatitis C awaiting renal transplant are limited by small patient numbers, poor design features, or both (Table 1). 6,[11][12][13][14][15][16][17][18][19] The clinical applicability of conventional IFN alfa monotherapy is captured in the results of two meta-analyses. 20,21 The first analysis 20 included 14 studies with 269 patients, and the second analysis 21 included 11 studies with 213 patients.…”