Efficacy and tolerance of α-2b interferon therapy on HCV infection of hemodialyzed patients

Abstract

A high frequency (25%) of anti-hepatitis C virus (HCV) antibodies is observed in French hemodialyzed patients; this is associated with detectable viremia in 85% and results in chronic hepatitis in more than 90%. We conducted a pilot study to examine the tolerance and efficacy of alpha-2b Interferon therapy upon HCV infection in hemodialyzed patients. Nineteen anti-HCV positive hemodialyzed patients were given a standard alpha-2b interferon regimen (3 megaunits subcutaneously three times weekly, following each hemodialysis) over six months as a treatment of biopsy-proven chronic hepatitis (N = 16) or acute hepatitis (N = 3). Thirteen of these 19 had increased levels of aminotransferase at the time of treatment. Serum HCV RNA was tested qualitatively and quantitatively by the polymerase chain reaction and the bDNA test, respectively, at the beginning and at the end of antiviral treatment, and a third time at least six months after the end of therapy (mean follow-up 18 +/- 9 months). HCV genotype was determined in the 15 patients who had detectable HCV RNA before treatment. The biological response (long-term response, relapse or non-response) was defined as usual according to the serum aminotransferase levels during therapy and at least six months after. A post-treatment liver biopsy, allowing comparison with semiquantitative pathological scores, was performed in 14 patients. Only one of the 19 treated patients did not complete therapy because of poor tolerance, while 18 of the 19 fairly tolerated a complete six month course of alpha-2b interferon.(ABSTRACT TRUNCATED AT 250 WORDS)

Side effects of ? interferon in chronic hepatitis C

“…Stopping therapy early may help blunt the severity of illness. However, transient thyroid abnormali-scribed in association with alpha interferon therapy of chronic hepatitis C. [78][79][80] The renal biopsy may show focal ties of little clinical significance can also occur during therapy. Some patients also develop transient hyperthyroid-segmental glomerulosclerosis and tubulointerstitial nephritis.…”

“…Nevertheless, alpha interferon therapy is reasonably well ism followed by prolonged hypothyroidism, with increases in serum tri-iodothyronine, thyroxine, and decreases in tolerated in hemodialyzed patients. 80,81 Renal impairment occurs in kidney transplant patients who appear to be particuthyroid-stimulating hormone levels, soon followed by low tri-iodothyronine and thyroxine values and increased serum larly liable to rejection of the kidney leading to impaired renal function. 81 thyroid-stimulating hormone levels.…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…On the other hand, these adverse effects generally disappeared completely with cessation of treatment. Among patients who had pre-and posttreatment liver biopsies, there was usually histological improvement as well (568,573,575). Thus, these results suggest that HCV-infected candidates with active HCV (indicated by RNA levels on polymerase chain reaction assay) should consider treatment with interferon alpha-2a.…”

“…Several small trials have examined the safety and efficacy of interferon alpha-2a treatment of hemodialysis patients (566)(567)(568)(569)(570)(571)(572)(573)(574)(575). Two of the trials were randomized and controlled (569,574).…”

Interferon for Hepatitis C Virus in Hemodialysis—an Individual Patient Meta-analysis of Factors Associated with Sustained Virological Response

“…Twenty studies met inclusion criteria ( Figure 1) with individual patient data published in 13 studies (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) and obtained for three additional studies after contacting authors (40 -42). Limited data based on inclusion criteria were imputed for the remaining four studies (43)(44)(45)(46), but no further data were provided despite multiple attempts to contact authors.…”