Low-dose Leukocyte Interferon-α Therapy in Dialysed Patients with Chronic Hepatitis C

Abstract

Kidney failure is a contraindication to interferon therapy, and active chronic hepatitis is incompatible with kidney transplantation. Our study was aimed at investigating the activity and tolerability of leukocyte interferon-alpha in patients undergoing pre-transplant dialysis and suffering from chronic active hepatitis due to Hepatitis C virus infection. Ten patients, with persistently high ALT levels, were treated with leukocyte interferon-alpha, at a dose of 1 MU three times weekly for one year. Viraemia, ALT levels and other blood and urine tests, hepatitis stage and drug tolerance were all monitored throughout the study and the six-month follow-up period. After six months of treatment, two patients had continuing normalisation of ALT, negative HCV-RNA tests and normalisation of histological features ('long-term responders'). Four patients relapsed; three did not respond to treatment; and one patient discontinued it because of intolerance. The four relapsing patients received a second cycle with the same interferon, at a dose of 3 MU three times weekly, with attainment, in one patient, of complete remittance after six months of follow-up. Leukocyte interferon-alpha yielded an overall 30% therapeutic response in dialysed patients with chronic hepatitis C. Its use is helpful in enabling dialysed patients to undergo transplantation.

Leukocyte Interferon Alpha Early Retreatment for Child A HCV Genotype 1b-Infected Cirrhotics Intolerant to Pegylated Interferons

“…Leukocyte IFN-alpha has in fact been used safely and efficaciously in heart transplant recipients, in dialyzed patients, and in the elderly [18][19][20][21]. In our experience, only one of 16 cirrhotic subjects (6.3%) who were retreated with leukocyte IFNalpha had to stop therapy again because of the reappearance of adverse events.…”

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

“…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.…”

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).…”