Pegylated Interferon-α2a With or Without Low-Dose Ribavirin for Treatment-Naive Patients With Hepatitis C Virus Genotype 1 Receiving Hemodialysis

Liu, Chen–Hua; Huang, Chung‐Feng; Liu, Chun‐Jen; Dai, Chia‐Yen; Liang, Cheng‐Chao; Huang, Jee‐Fu; Hung, Peir-Haur; Tsai, Hung-Bin; Tsai, Min Kuang; Chen, Shih‐I; Lin, Jou‐Wei; Yang, Sheng‐Shun; Su, Tung‐Hung; Yang, Hung‐Chih; Chen, Pei‐Jer; Chen, Ding‐Shinn; Chuang, Wan‐Long; Yu, Ming‐Lung; Kao, Jia‐Horng

doi:10.7326/0003-4819-159-11-201312030-00005

Cited by 97 publications

(90 citation statements)

References 42 publications

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“…Despite the fact that ribavirin is contraindicated in the setting of renal failure, this drug can be used at markedly reduced daily doses and with careful monitoring for anemia. Patients can be started on a low dose of ribavirin, and doses can be increased gradually as long as side effects are manageable [82][83][84] . Only a few reports support the combined use of pegIFN and ribavirin in ESRD patients or patients on HD (Table 1).…”

Section: Combination Therapies: Interferon or Pegifn With Ribavirinmentioning

confidence: 99%

Hepatitis C infection in hemodialysis patients: A review

Etık

Öcal

Boyacioglu

2015

WJH

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Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications posttransplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.

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Section: Combination Therapies: Interferon or Pegifn With Ribavirinmentioning

confidence: 99%

Hepatitis C infection in hemodialysis patients: A review

Etık

Öcal

Boyacioglu

2015

WJH

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“…134, 135 Liu et al further evaluated PEG-IFN α-2a at a dose of 135 µg per week plus RBV at a dose of 200 mg per day for 48 and 24 weeks in treatment-naïve and -experienced East Asian HCV-1 and HCV-2 patients on hemodialysis. 130,131,136 The SVR rates for treatment-naïve HCV-1 and HCV-2 patients were 64% and 74%, respectively; those for treatment-experienced HCV-1 and HCV-2 patients were 52% and 80%, respectively. Furthermore, Tseng et al evaluated PEG-IFN α-2b at a dose of 1.0 µg per kg of body weight per week plus RBV at a dose of 200 mg three times per week for 48 and 24 weeks in treatment-naïve East Asian HCV-1 and non-HCV-1 patients on hemodialysis, and the overall SVR rate was 62%.…”

mentioning

confidence: 99%

“…[129][130][131] Two recent pilot studies used TVR in combination with PEG-IFN α plus low-dose RBV to treat Western HCV-1 patients on hemodialysis, and the SVR rates were superior to those using PEG-IFN α plus low-dose RBV. 137,138 Whether triple therapy or all oral DAA regimen could benefit Asian patients on hemodialysis deserves further investigation.…”

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confidence: 99%

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Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

Liu¹,

Kao

2014

IJN

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Asia is endemic for hepatitis C virus (HCV) infection, which is the leading cause of cirrhosis, hepatic decompensation, hepatocellular carcinoma, and liver transplantation worldwide. HCV has six major genotypes and each HCV genotype has its specific geographic distribution. HCV genotypes 1, 2, 3, and 6 are common in Asia. The aim of HCV treatment is to eradicate the virus by effective therapeutic agents; viral clearance is durable after long-term post-treatment follow-up. In most Asian countries, peginterferon alfa (PEG-IFN α) in combination with ribavirin remains the standard of care, and the overall sustained viral response (SVR) rate in Asian HCV patients is higher than that in Western patients. The differences are most significant in patients with HCV genotype 1 (HCV-1) infection, which is attributed to the higher frequency of IFN-responsive or favorable interleukin-28B (IL-28B) genotype in Asian populations than in other ethnic populations. In addition, the introduction of response-guided therapy, where the optimized treatment duration is based on the early viral kinetics during the first 12 weeks of treatment, increases the SVR rate. Recently, telaprevir or boceprevir-based triple therapy was found to further improve the SVR rate in treated and untreated HCV-1 patients and has become the new standard of care in Western and some Asian countries. Many novel direct-acting antiviral agents, either in combination with PEG-IFN α plus ribavirin or used as IFN-free regimens are under active investigation. At the time of this writing, simeprevir and sofosbuvir have been approved in the US. Because the SVR rates in Asian HCV patients receiving PEG-IFN α plus ribavirin therapy are high, health care providers should judiciously determine the clinical usefulness of these novel agents on the basis of treatment duration, anticipated viral responses, patient tolerance, financial burdens, and drug accessibility.

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“…9,10 However, several studies reported the use of low-dose ribavirin in combination with interferon, carefully controlling for anemia and monitoring serum concentration of the drug during treatment in hemodialysis patients. [11][12][13] The primary goal of the antivirological treatment is eradication of the HCV infection, which is synonymous with sustained virological response (SVR). The antivirological treatment is prolonged and expensive, complicated by frequent and sometimes serious side effects resulting in treatment discontinuation, and about one-third of the treated hemodialysis patients achieve sustained virological response.…”

Section: Introductionmentioning

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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Pegylated Interferon-α2a With or Without Low-Dose Ribavirin for Treatment-Naive Patients With Hepatitis C Virus Genotype 1 Receiving Hemodialysis

Abstract: National Center of Excellence for Clinical Trial and Research.

Cited by 97 publications

References 42 publications

Hepatitis C infection in hemodialysis patients: A review

Hepatitis C infection in hemodialysis patients: A review

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

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

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