Efficacy of interferon for chronic hepatitis C virus–related hepatitis in kidney transplant candidates on hemodialysis: results after transplantation

Casanovas-Taltavull, Teresa; Baliellas, Carme; Benasco, C; Serrano, Teresa; Casanova, Aurora; Pérez, José Luís; Guerrero, Lourdes; González, M. Teresa; Andrés, E; Gil-Vernet, S.; Casais, L

doi:10.1016/s0002-9270(01)02260-2

Cited by 30 publications

(26 citation statements)

References 32 publications

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“…Uchihara M, et al [44] Benci A, et al [45] Chan T.M, et al [43] Izopet J, et al [42] Campistol J.M, et al [48] Hanrotel C, et al [52] Espinosa M, et al [49] Fernandez J.L, et al [41] Huraib S, et al [51] Mean overall estimate Koenig P, et al [33] Casanovas-Taltavull T, et al [50] Raptopoulou-Gigi M, et al [39] Pol S, et al [38] Degos F, et al [53] Patients discontinued treatment (%) -10% 10% 20% 30% 40% 50% 60% 70% 80% 90% 0% be the best descriptive analysis, since they assume that all estimates from individual studies are from the same population. The sources of between study heterogeneity are unclear.…”

Section: Heterogeneity Analysismentioning

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: Heterogeneity Analysismentioning

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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“…To compare our results to studies of non-HD patients, we determined the raw probability of long-term virological negativity for two groups, which was 92% and 93% for HD patients and kidney transplant recipients with median 18 and 20 months of follow-up, respectively. Adding the virological outcomes of the 22 excluded patients with long-term virological negativity before transplantation, but without specified follow-up time on HD (38,39), increased the probability of HCV RNA negativity in the HD group to 93%. These results in HD patients are comparable to those observed in non-HD patients (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…Of 21 IFN treatment studies, 16 reported patient-level data on long-term virological outcomes following SVR (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), and of 21 pegylated-IFN studies, six studies provided such data (41)(42)(43)(44)(45)(46). For unpublished data on long-term HCV RNA outcomes, we directly contacted authors.…”

Section: Patient Selection For Long-term Hcv Rna Analysismentioning

confidence: 99%

“…Those who were HCV RNA negative 48 months after SVR (n ϭ 10) remained negative through last follow-up (62 to 78 months after SVR). An additional 22 patients from two studies (38,39) achieved SVR after IFN and remained HCV RNA negative on HD before undergoing kidney transplantation but were not analyzed because follow-up time on HD was not specified.…”

Section: Long-term Persistence Of Hcv Rna Negativitymentioning

confidence: 99%

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Long-Term Viral Negativity After Interferon for Chronic Hepatitis C Virus Infection in Hemodialysis

Gordon¹,

Uhlig²,

Schmid³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Interferon (IFN) and pegylated-IFN treatment of hepatitis C virus (HCV) infection in hemodialysis patients result in sustained virological response (SVR) rates of 45% and 37%, respectively. Although most nonhemodialysis patients who achieve SVR remain persistently viral negative, the durability of SVR in hemodialysis patients is unknown. We analyzed the rate of long-term virological negativity in hemodialysis patients who achieved SVR after IFN or pegylated-IFN through analysis of patientlevel data.Design, setting, participants, & measurements After performing a systematic literature review for IFN-based treatment of hemodialysis patients with chronic HCV infection, we extracted patient-level data on patients who achieved SVR. We performed life table analysis to estimate long-term virological negativity rates after SVR in patients who continued on hemodialysis or subsequently underwent kidney transplantation.Results Long-term HCV RNA outcomes following SVR were available for 121 hemodialysis patients (20 studies) and 45 patients who subsequently underwent transplantation (11 studies). The probability of remaining HCV RNA negative was 86% (95% confidence interval, 77% to 96%) for patients followed on hemodialysis 48 months after SVR and 95% (95% confidence interval, 89% to 100%) for kidney recipients followed 48 months after transplant.Conclusions Viral negativity from IFN-based HCV treatment in hemodialysis patient appears durable during extended follow-up, including after kidney transplantation. The certainty of the viral negativity estimate is limited by the small number with follow-up beyond 48 months or longer. Transplantation does not confer an increased risk of relapse. Future research should investigate whether IFN-based treatment improves clinical outcomes for hemodialysis patients.

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“…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.…”

Section: Study Characteristicsmentioning

confidence: 99%

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

Gordon¹,

Uhlig²,

Lau

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Hepatitis C virus (HCV) infection is prevalent in hemodialysis patientsResults: Twenty studies of IFN treatment provided data on 428 patients. Overall SVR was 45% and in univariate analyses was higher with: 1) three million units or higher three times weekly of IFN; 2) treatment for at least 6 mo; 3) treatment completion; 4) lower baseline HCV RNA; 5) female gender; and 6) early virological negativity. Although limited by missing data, these relationships persisted in multivariate regression.Conclusions: SVR is more likely with larger IFN dose, longer treatment duration, treatment completion, female gender, lower HCV RNA and early virological negativity. For appropriate treatment candidates, regimens should consist of three million units of IFN three times weekly for at least 6 mo, with patients encouraged to complete the full course.

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Efficacy of interferon for chronic hepatitis C virus–related hepatitis in kidney transplant candidates on hemodialysis: results after transplantation

Cited by 30 publications

References 32 publications

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

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

Long-Term Viral Negativity After Interferon for Chronic Hepatitis C Virus Infection in Hemodialysis

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

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