Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

Liu, Chen–Hua; Liang, Cheng‐Chao; Liu, Chun‐Jen; Lin, Jou‐Wei; Chen, Shih‐I; Hung, Peir-Haur; Tsai, Pi‐Ru; Lai, Ming-Yang; Chen, Pei‐Jer; Chen, Ding‐Shinn

doi:10.1086/655682

Cited by 32 publications

(28 citation statements)

References 40 publications

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“…The incidence and prevalence rates of HCV infection in haemodialysis patients are much greater than those in the general population and are attributed to high rates of nosocomial transmission 4 5. Compared with haemodialysis patients who do not have HCV infection, haemodialysis patients with HCV infection have increased risks of liver-related morbidity and mortality 6.…”

Section: Introductionmentioning

confidence: 99%

Peginterferon alfa-2a with or without low-dose ribavirin for treatment-naive patients with hepatitis C virus genotype 2 receiving haemodialysis: a randomised trial

Liu

Huang

et al. 2014

Gut

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Section: Introductionmentioning

confidence: 99%

Peginterferon alfa-2a with or without low-dose ribavirin for treatment-naive patients with hepatitis C virus genotype 2 receiving haemodialysis: a randomised trial

Liu

Huang

et al. 2014

Gut

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“…The annual incidence and prevalence rates of HCV infection range from 0.22 to 6.20% and 3.4 to 80%, respectively, by different geographic distributions (1)(2)(3)(4)(5). Although hemodialysis patients with chronic HCV infection are usually asymptomatic with mildly elevated serum alanine aminotransferase (ALT) levels, previous studies indicate that they are at increased risk of liver-related morbidity and mortality, either at the dialysis or postrenal transplantation stage (6 -8).…”

Section: Introductionmentioning

confidence: 99%

Transient Elastography to Assess Hepatic Fibrosis in Hemodialysis Chronic Hepatitis C Patients

Liu¹,

Liang²,

Huang³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Although percutaneous liver biopsy (PLB) is the gold standard for staging hepatic fibrosis in hemodialysis patients with chronic hepatitis C (CHC) before renal transplantation or antiviral therapy, concerns exist about serious postbiopsy complications. Using transient elastography (TE, Fibroscan) to predict the severity of hepatic fibrosis has not been prospectively evaluated in these patients.Design, setting, participants, & measurements A total of 284 hemodialysis patients with CHC were enrolled. TE and aspartate aminotransferase-to-platelet ratio index (APRI) were performed before PLB. The severity of hepatic fibrosis was staged by METAVIR scores ranging from F0 to F4. Receiver operating characteristic curves were used to assess the diagnostic accuracy of TE and APRI, taking PLB as the reference standard. ResultsThe areas under curves of TE were higher than those of APRI in predicting patients with significant hepatic fibrosis (ՆF2) (0.96 versus 0.84, P Ͻ 0.001), those with advanced hepatic fibrosis (ՆF3) (0.98 versus 0.93, P ϭ 0.04), and those with cirrhosis (F4) (0.99 versus 0.92, P ϭ 0.13). Choosing optimized liver stiffness measurements of 5.3, 8.3, and 9.2 kPa had high sensitivity (93-100%) and specificity (88 -99%), and 87, 97, and 93% of the patients with a fibrosis stage of ՆF2, ՆF3, and F4 were correctly diagnosed without PLB, respectively.Conclusions TE is superior to APRI in assessing the severity of hepatic fibrosis and can substantially decrease the need of staging PLB in hemodialysis patients with CHC.

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“…36,119 Many Asian experts treated dialysis patients with HCV infection by using PEG-IFN α-2a or PEG-IFN α-2b monotherapy for 24-48 weeks. [120][121][122][123][124][125][126][127][128][129] However, the SVR rates varied widely (from 0%-100%) because of small sample size, heterogeneous population, and divergent regimens. Recently, two large-scale trials evaluated East Asian HCV-1 and HCV-2 hemodialysis patients receiving PEG-IFN α-2a for 48 and 24 weeks, and the SVR rates …”

Section: Peginterferon α With or Without Rbv Therapy In A Special Popmentioning

confidence: 99%

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

Liu¹,

Kao

2014

IJN

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Asia is endemic for hepatitis C virus (HCV) infection, which is the leading cause of cirrhosis, hepatic decompensation, hepatocellular carcinoma, and liver transplantation worldwide. HCV has six major genotypes and each HCV genotype has its specific geographic distribution. HCV genotypes 1, 2, 3, and 6 are common in Asia. The aim of HCV treatment is to eradicate the virus by effective therapeutic agents; viral clearance is durable after long-term post-treatment follow-up. In most Asian countries, peginterferon alfa (PEG-IFN α) in combination with ribavirin remains the standard of care, and the overall sustained viral response (SVR) rate in Asian HCV patients is higher than that in Western patients. The differences are most significant in patients with HCV genotype 1 (HCV-1) infection, which is attributed to the higher frequency of IFN-responsive or favorable interleukin-28B (IL-28B) genotype in Asian populations than in other ethnic populations. In addition, the introduction of response-guided therapy, where the optimized treatment duration is based on the early viral kinetics during the first 12 weeks of treatment, increases the SVR rate. Recently, telaprevir or boceprevir-based triple therapy was found to further improve the SVR rate in treated and untreated HCV-1 patients and has become the new standard of care in Western and some Asian countries. Many novel direct-acting antiviral agents, either in combination with PEG-IFN α plus ribavirin or used as IFN-free regimens are under active investigation. At the time of this writing, simeprevir and sofosbuvir have been approved in the US. Because the SVR rates in Asian HCV patients receiving PEG-IFN α plus ribavirin therapy are high, health care providers should judiciously determine the clinical usefulness of these novel agents on the basis of treatment duration, anticipated viral responses, patient tolerance, financial burdens, and drug accessibility.

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Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

Abstract: Pegylated IFN alfa-2a monotherapy is safe and efficacious for hemodialysis patients with acute hepatitis C. It is suggested that patients without spontaneous clearance of HCV by week 16 should receive therapy.

Cited by 32 publications

References 40 publications

Peginterferon alfa-2a with or without low-dose ribavirin for treatment-naive patients with hepatitis C virus genotype 2 receiving haemodialysis: a randomised trial

Peginterferon alfa-2a with or without low-dose ribavirin for treatment-naive patients with hepatitis C virus genotype 2 receiving haemodialysis: a randomised trial

Transient Elastography to Assess Hepatic Fibrosis in Hemodialysis Chronic Hepatitis C Patients

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

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