Interferon Treatment in Hemodialysis Patients With Chronic Hepatitis C Virus Infection: A Systematic Review of the Literature and Meta-analysis of Treatment Efficacy and Harms

Gordon, Craig E.; Uhlig, Katrin; Lau, Joseph; Schmid, Christopher H.; Levey, Andrew S.; Wong, John B.

doi:10.1053/j.ajkd.2007.11.003

Cited by 120 publications

(110 citation statements)

References 51 publications

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“…IFN treatment of chronic HCV infection in HD patients results in a 45% SVR, significantly higher than the 10 to 20% rate reported for IFN monotherapy in non-HD patients (7)(8)(9)22). This difference may be related to lower IFN clearance in HD a Sensitivity analysis using adverse event as outcome did not reveal any statistically significant relationships except when compared with 3 MU and 1 to 1.5 MU dosing, 5 to 6 MU of interferon had an OR of an adverse event of 1.9 (95% confidence interval, 1.1 to 3.4) and 5.0 (1.5 to 16.3), respectively.…”

Section: Discussionmentioning

confidence: 75%

“…The literature search strategy and study selection process for our systematic review have been described previously (22). We included prospective studies of IFN-based treatment of HD patients with chronic HCV infection and with reported SVR at 5 mo or more after treatment completion.…”

Section: Study Selectionmentioning

confidence: 99%

“…Using individual patient data, we investigated the relationship between SVR and patient, viral, and treatment characteristics based on factors previously identified in non-HD patients (7)(8)(9), HD patients (25,26), and our previous meta-analysis of summary data (22). Patient factors included age, gender, duration of HD, and previous kidney transplantation.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…IFN treatment after kidney transplantation is associated with increased rates of allograft rejection (19,20), so treatment before transplantation is advised (21,22). Our recent meta-analysis of summary data in HCVinfected HD patients demonstrated an overall SVR rate of 41% with IFN (22), higher than rates in IFN-treated non-HD patients (7,8), but rates of treatment discontinuation due to adverse events were also higher (22).…”

mentioning

confidence: 99%

“…The majority of studies of IFN in HD patients reported individual patient data, allowing us to extend our prior subgroup analysis and metaregression of summary data (22) to identify factors associated with SVR.…”

mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 75%

Section: Study Selectionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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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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HepatitisCVirus (HCV) Infection: in Special Situations

Koukoulioti

Berg

2019

Evidence‐based Gastroenterology and Hepatology 4e

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Asunaprevir and daclatasvir in hemodialysis patients with chronic hepatitis C virus genotype 1b infection

et al. 2017

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Background and AimPatients requiring hemodialysis show high morbidity with hepatitis C virus (HCV) infection, but there are difficulties associated with interferon‐based therapies. Asunaprevir and daclatasvir could help patients with HCV genotype 1b because the drugs have a nonrenal metabolism and show good viral eradication. We evaluated the efficacy and safety of combined asunaprevir and daclatasvir therapy.MethodsThis was a multicenter prospective trial of patients with chronic hepatitis or compensated cirrhosis from HCV genotype 1b who had end‐stage renal disease requiring chronic hemodialysis. Asunaprevir and daclatasvir were administered orally (100 mg twice daily and 60 mg once daily, respectively) for 24 weeks. The primary end‐point was the proportion of patients achieving sustained virological response 12, defined as HCV RNA <15 IU/mL undetectable at 12 weeks after completion of asunaprevir and daclatasvir treatment.ResultsBetween December 2014 and December 2015, 23 dialysis patients were enrolled, and 22 patients completed the protocol therapy. Sustained virological response 12 rates were 91.3% (95% confidence interval: 72.0–98.9) in the intention‐to‐treat and 95.5% (95% confidence interval: 77.2–99.9) in the per‐protocol populations. Serum aminotransferase significantly decreased after initiation of asunaprevir and daclatasvir (P < 0.01), although the level was low at baseline. Asunaprevir and daclatasvir were well tolerated; however, one patient could not continue because of infective endocarditis and cerebral infarction.ConclusionsAsunaprevir and daclatasvir could help patients with chronic hepatitis C receiving hemodialysis. Close collaboration with dialysis physicians is important when treating these patients because hemodialysis carries life‐threatening risks.

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Interferon Treatment in Hemodialysis Patients With Chronic Hepatitis C Virus Infection: A Systematic Review of the Literature and Meta-analysis of Treatment Efficacy and Harms

Cited by 120 publications

References 51 publications

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

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

HepatitisCVirus (HCV) Infection: in Special Situations

Asunaprevir and daclatasvir in hemodialysis patients with chronic hepatitis C virus genotype 1b infection

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