Treatment of Chronic Hepatitis C With Recombinant Interferon Alpha in Kidney Transplant Recipients

Rostaing, Lionel; Izopet, Jacques; Baron, Emmanuel; Duffaut, M; Puel, J; Durand, Dominique

doi:10.1097/00007890-199505270-00012

Cited by 196 publications

(116 citation statements)

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“…Its use is not recommended after renal transplantation due to a significant risk of graft loss. [20][21][22][23] Adverse consequences on long-term graft and patient survival related to the presence of HCV infection after kidney [24][25][26][27][28][29] and kidney-pancreas 30 transplantation have been clearly established. Thus, it is imperative that safe and effective therapy for chronic HCV infection be administered prior to renal transplantation.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

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SUMMARYBackground: The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. Methods and aims: We evaluated the efficacy and safety of initial interferon monotherapy in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical trials. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). We used the random effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses. Results: We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop-out rate was 37% [95% confidence interval (CI) 28-48] and 17% (95% CI 10-28),

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Section: Introductionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

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“…76,84 HCV Treatment in the KT Recipient For the last two decades, the treatment of HCV infection in the post-transplant setting has not been an option in large part because of the unacceptable risk of rejection associated with the use of IFNbased regimens. [84][85][86][87] Furthermore, the IFNs are poorly tolerated, and SVR rates are only in the 45%-50% range. 88 As a consequence of this poor efficacy and high adverse event profile, treatment of HCV infection in the KT candidate and recipient has often been deferred.…”

Section: Grazoprevir and Elbasvirmentioning

confidence: 99%

Hepatitis C Virus Infection in Chronic Kidney Disease

Ladino

Pedraza

Roth

2016

JASN

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Soon after the hepatitis C virus (HCV) was identified in 1989, it was recognized that the prevalence of infection in patients with ESRD far exceeded that in the general population. Infection with HCV predisposes to the hepatic complications of cirrhosis and hepatocellular carcinoma. However, important extrahepatic manifestations include immune complex glomerular disease, accelerated progression of CKD, increases in cardiovascular event risk, and lymphoproliferative disorders. Advances in understanding the molecular biology of HCV have ushered in a new era in the treatment of this infection. Second generation direct-acting antiviral agents have revolutionized therapy, with sustained virologic response rates (undetectable viral load 12 weeks after completing therapy) of .90% in most patients. Studies using direct-acting antivirals in patients with CKD and those on dialysis are showing excellent safety and efficacy as well. In this context, it is imperative that nephrologists become familiar with this literature, reviewed here, so that the important decisions, including which patients should be treated and the optimal timing to initiate therapy, are vetted in association with the compounding issues of CKD, ESRD, and kidney transplantation.

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“…Interferon is effective for viral eradication in HCV-infected patients, especially when combined with ribavirin. However, the administration of interferon after kidney transplantation can be deleterious to the allograft and should generally be avoided in KTRs, unless there is indication of worsening hepatic injury (Rostaing et al, 1995). It would be best if treatment could be undertaken before proceeding to the solid organ transplant.…”

Section: Pretransplant Antiviral Therapymentioning

confidence: 99%