Virological responses of pegylated interferon alpha-2a treatment in hemodialysis patients infected with hepatitis C

Köse, Şükran; Senger, Süheyla Serin; Ersan, Gürsel; Çavdar, Gülsün

doi:10.1007/s10157-012-0663-x

Cited by 5 publications

(6 citation statements)

References 29 publications

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“…Sixteen reports were excluded because they contained duplicate reports of the same patients ( N = 2) and did not fulfill the inclusion criteria ( N = 14). A total of 24 reports giving information on 744 unique patients undergoing long‐term dialysis were included in our meta‐analysis . There was a 100% concordance between reviewers with respect to final inclusion and exclusion of studies reviewed based on the predefined and exclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Pegylated Interferon Mono‐Therapy of Chronic Hepatitis C in the Dialysis Population: Systematic Review and Meta‐Analysis

2015

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The medical literature on mono-therapy with pegylated interferon for chronic hepatitis C in dialysis patients is mostly based on small clinical studies and the efficacy and safety of such approach is still unclear. A systematic review of the literature with a meta-analysis of clinical studies was performed in order to evaluate the efficacy and safety of mono-therapy with pegylated interferon of chronic hepatitis C in patients on regular dialysis. The primary outcome was sustained viral response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). The random-effects model of Der Simonian and Laird was used, with heterogeneity and sensitivity analyses. Twenty-four clinical studies (N = 744 unique patients) were retrieved; five (21%) being randomized controlled trials. The summary estimate for sustained viral response and drop-out rate was 0.40 (95% confidence interval [CI], 0.35; 0.46) and 0.14 (95% CI, 0.09; 0.20), respectively. The most frequent side-effects requiring discontinuation of treatment were hematological (31/83 = 37%) and gastrointestinal (9/31 = 10.8%). Meta-regression analysis showed a detrimental role of ageing on the frequency of sustained virological response (P = 0.01); drop-out rate was greater in diabetics (P < 0.005). Important heterogeneity was seen with regard to drop-out rate only. In summary, pegylated interferon monotherapy of hepatitis C in dialysis patients resulted unsatisfactory in terms of efficacy and safety. Studies with novel direct-acting antiviral agents in combination with pegylated interferon and ribavirin for the treatment of hepatitis C virus in dialysis population are under way.

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Section: Resultsmentioning

confidence: 99%

Pegylated Interferon Mono‐Therapy of Chronic Hepatitis C in the Dialysis Population: Systematic Review and Meta‐Analysis

2015

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“…Regarding IFN monotherapy in hemodialysis patients with chronic HCV infection, there are limited data in Turkey provided from studies of small series, and SVR rates vary between 46.1-75% in these series. Apart from our case report, we could not encounter a study subjecting ribavirin or protease inhibitor usage in hemodialysis patients in Turkey [3,[19][20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Kaygusuz¹,

Gül²,

Gülhan³

2014

Mediterr J Infect Microb Antimicrob

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Chronic hepatitis C virus (HCV) infection is more prevalent and has been proven to be an independent risk factor over mortality among hemodialysis patients than normal population. Since sustained virologic response (SVR) is so beneficial and may be maintained in 90-100% of post-transplant cases, treatment of chronic HCV infection is strongly suggested for all patients undergoing renal transplantation. A 45-year-old male patient had been offered to have renal transplantation due to chronic renal failure, and referred to our clinic because of chronic HCV infection (HCV-RNA positive). He had received hemodialysis three times a week since 2007. The patient was diagnosed with chronic HCV infection fifteen years ago and was given a 48-week lasting IFN therapy in 2000 and a subsequent therapy of PEG-IFN-α2a for 48 weeks in 2004. Although both therapies had yielded end of treatment responses, subsequent relapses occurred. The patient was given a combination treatment involving PEG-IFN-α2a (135 μg/wk) for 24 weeks and ribavirin (200 mg/day) for 24 weeks and telaprevir (3 x 750 mg) for the first 12 weeks, and a weekly control visit in our clinic. The therapy was generally well tolerated and SVR was achieved. Triple therapy might be used as a treatment option in hemodialysis patients with genotype 1 chronic HCV infections.

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“…The same treatment response rate of 50% was reported by Kose et al PEG IFNa-2a as a monotherapy (135 mg/weekly) was given to 38 hemodialysis patients with chronic hepatitis C for 48 weeks. 29 There was no other published study about the association between the IL28B gene polymorphisms and response to HCV infection treatment in hemodialysis patients. Yu et al identified association of one polymorphism (rs8099917) and HCV infection clearance in hemodialysis patients, but the clearance of HCV infection was spontaneous, and not treatment induced as it was in our study.…”

Section: Disscusionmentioning

confidence: 99%

“…Recent studies of hepatitis C treatment in hemodialysis patients, with PEG IFNa-2a, included between 13 and 40 patients. 29,[34][35][36] However, it has to be taken into consideration that roughly 20% of the treated patients with favorable CC genotype of rs12979860 did not achieve SVR, 37 due to dynamic interactions between genes or between genes and environment. 38 Other factors such as ethnicity and HCV genotype should be used together with IL28B genotype as pretreatment predictors for response.…”

Section: Disscusionmentioning

confidence: 99%

Single nucleotide polymorphisms near IL28B gene and response to treatment of chronic hepatitis C in hemodialysis patients

Dzekova‐Vidimliski¹,

Nikolov²,

Matevska-Geshkovska

et al. 2015

Renal Failure

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Background: It has been shown that single nucleotide polymorphisms (SNPs) near the interleukin 28B (IL28B) gene were associated with sustained virological response following standard antivirological treatment of chronic hepatitis C. Objectives: The aim of the study was to evaluate the association between SNPs near the IL28B gene and response to the treatment of chronic hepatitis C in hemodialysis patients. Patients and methods: The study group included 24 hemodialysis patients with chronic hepatitis C routinely treated with pegylated interferon a-2 a. HCV genotype 1 was the cause of chronic hepatitis C in all study participants. Sustained virological response was determined by an assay with a sensitivity of 20 IU/mL, 6 months after completion of the antivirological treatment. The genotyping of the three most widely studied IL28B gene polymorphisms (rs12979860, rs8099917, and rs12980275) was performed in all study participants. Results: Sustained virological response was achieved in 50% of the treated patients. The treatment response was significantly associated with the CC genotype of rs12979860, TT genotype of rs8099917, and AA genotype of rs12980275 (p ¼ 0.003, p ¼ 0.009, and p ¼ 0.012, respectively). Conclusions: The three most widely studied SNPs near the IL28B gene were associated with sustained virological response following antivirological treatment of chronic hepatitis C in hemodialysis patients.

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Virological responses of pegylated interferon alpha-2a treatment in hemodialysis patients infected with hepatitis C

Cited by 5 publications

References 29 publications

Pegylated Interferon Mono‐Therapy of Chronic Hepatitis C in the Dialysis Population: Systematic Review and Meta‐Analysis

Pegylated Interferon Mono‐Therapy of Chronic Hepatitis C in the Dialysis Population: Systematic Review and Meta‐Analysis

Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Single nucleotide polymorphisms near IL28B gene and response to treatment of chronic hepatitis C in hemodialysis patients

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