Preliminary Results of Treatment With Pegylated Interferon Alpha 2A for Chronic Hepatitis C Virus in Kidney Transplant Candidates on Hemodialysis

Casanovas-Taltavull, Teresa; Baliellas, Carme; Llobet, M.; Cruzado, Josep M.; Castellote, José; Casanova, Aurora; Niubó, Jordi; Valls, Carlos; Serrano, Teresa

doi:10.1016/j.transproceed.2007.07.013

Cited by 25 publications

(24 citation statements)

References 9 publications

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“…Three studies concerned pegylated IFN for acute hepatitis C [Engel et al, 2007;Griveas et al, 2007;Lederer et al, 2008]. The remaining 16 studies [Mukherjee et al, 2003;Annichiarico and Siciliano, 2004;Rivera et al, 2005;Teta et al, 2005;Covic et al, 2006;Russo et al, 2006;Sporea et al, 2006;Amarapurkar et al, 2007;Casanovas-Taltavull et al, 2007;Chan et al, 2007;Espinosa et al, 2007;Akhan et al, 2008;Ayaz et al, 2008;Liu et al, 2008;Sikole et al, 2008;UcMak et al, 2008] representing a total of 254 unique patients, were included in the metaanalysis.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Based on the data provided it appears that the majority of enrolled subjects were patients with HCV genotype 1. Information on liver histology was given only in five studies-the rate of cirrhotic patients ranged between 0% [Rivera et al, 2005;Amarapurkar et al, 2007;Casanovas-Taltavull et al, 2007] and 33% [Teta et al, 2005]. Table III provides details on the study design, including dose and duration of peg-IFN therapy.…”

Section: Shown Inmentioning

confidence: 99%

“…Casanovas-Taltavull et al [2007] Ucmak et al [2008] 6 (50) 9 (75%) 8 (0.80) NA Sikole et al [2008] 5 (41.6) 8 (57.1) NA NA Liu et al [2008] 12 (48) 23 (92) NA NA Ayaz et al [2008] 11 (50) Mukherjee et al [2003] a 8 (89) Diplopia (n ¼ 1), headache (n ¼ 1), depression (n ¼ 2), fatigue (n ¼ 1), liver insufficiency (n ¼ 2) Annichiarico and Siciliano [2004] 2 (33) Anemia (n ¼ 1), diarrhoea (n ¼ 1) Teta et al [2005] 1 (33) Pneumonia Rivera et al [2005] 1 (14) Pancytopenia Russo et al [2006] 7 (44) Hypertension (n ¼ 2), seizures (n ¼ 1), infection (n ¼ 2), graft necrosis (n ¼ 1), dehydratation (n ¼ 1) Covic et al [2006] 11 (14) Acute abdomen (n ¼ 1), depression (n ¼ 1), stroke (n ¼ 2), sepsis (n ¼ 4), thrombocytopenia (n ¼ 3) Chan et al [2007] 2 (33) Cholangitis (n ¼ 1), ischaemic heart disease (n ¼ 1) Espinosa et al [2007] 6 (37.5) Acute abdomen (n ¼ 1), seizures (n ¼ 1), neutropenia (n ¼ 1), heart disease (n ¼ 1), vasculitis (n ¼ 1), prostatic carcinoma (n ¼ 1) Casanovas-Taltavull et al [2007] 3 (25) Fever (n ¼ 1), anemia (n ¼ 1), stroke (n ¼ 1) Sikole et al [2008] 3 (21) Pericarditis (n ¼ 1), pneumonia (n ¼ 1), cerebral hemorrhage (n ¼ 1) Ayaz et al [2008] 5 (23) Anaemia (n ¼ 2), weakness (n ¼ 2), gastrointestinal bleeding (n ¼ 1)…”

Section: Heterogeneity Analysismentioning

confidence: 99%

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Pegylated interferon monotherapy of chronic hepatitis C in dialysis patients: Meta‐analysis of clinical trials

Fabrizi

Dixit

Messa

et al. 2010

Journal of Medical Virology

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The efficacy and safety of pegylated interferon monotherapy in patients with chronic renal failure and chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. A systematic review of the literature with a meta-analysis of clinical trials was performed in order to assess efficacy and safety of initial pegylated interferon monotherapy in chronic renal failure patients with chronic hepatitis C. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). The random effects model of Der Simonian and Laird was used, with heterogeneity and sensitivity analyses. Sixteen clinical trials (254 unique patients) were identified, five (31%) being controlled studies; the majority (15/16 = 94%) regarded patients on long-term dialysis. The summary estimate for sustained virological response and drop-out rate was 33% [95% Confidence Intervals (95%CI) 24-43] and 23% (95%CI, 14-33), respectively. The most frequent side-effects requiring interruption of treatment were haematological (18%) and gastrointestinal (14%). In the group of controlled clinical trials, the summary estimate for sustained viral response and drop-out rate was 38% (95% CI, 18-59), and 15% (95% CI, 3-26), respectively. The studies were heterogeneous with regard to sustained virological response and drop-out rate. Pegylated IFN does not provide an added benefit in terms of virological response in comparison with standard IFN monotherapy. Tolerance to pegylated-IFN monotherapy was unsatisfactory. Prospective trials are in progress to assess the optimal antiviral therapy for chronic hepatitis C in dialysis patients.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Shown Inmentioning

confidence: 99%

Section: Heterogeneity Analysismentioning

confidence: 99%

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Pegylated interferon monotherapy of chronic hepatitis C in dialysis patients: Meta‐analysis of clinical trials

Fabrizi

Dixit

Messa

et al. 2010

Journal of Medical Virology

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“…HCV is associated with worse patient and graft survival as well as an increased risk for post-transplant diabetes mellitus and de novo glomerulopathy. Eradication of HCV before transplant might mitigate some of these adverse outcomes (Cruzado, Casanovas-Taltavull et al 2003;Casanovas-Taltavull, Baliellas et al 2007). Furthermore, IFN therapy after transplantation is associated with reduced treatment response rates, a greater incidence of organ rejection, and impairment of renal function (Rostaing, Izopet et al 1995).…”

Section: Treatmentmentioning

confidence: 99%

Viral Hepatitis in Solid Organ Transplant Recipients

Lisa¹,

Levitsky²

2011

Viral Hepatitis - Selected Issues of Pathogenesis and Diagnostics

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“…Several studies have investigated PEG-IFN alfa monotherapy for hepatitis C in patients with renal dysfunction. [24][25][26][27][28][29][30][31][32] However, most studies were small and included 10 patients or fewer; only four studies included more than 10 patients. 24,25,31,32 Common results included low SVR rates and an unfavorable tolerability profile.…”

Section: Hemodialysis Patients With Chronic Hepatitis C Awaiting Renamentioning

confidence: 99%

Treatment of chronic hepatitis C in hemodialysis patients

Berenguer

2008

Hepatology

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Hepatitis C virus (HCV) infection is especially problematic in patients with end-stage renal disease (ESRD) who are undergoing hemodialysis. Rates of HCV infection are higher among hemodialysis patients than in the general population, and several routes of transmission are thought to stem from the dialysis unit. Management of chronic hepatitis C is also more complicated in hemodialysis patients because of altered pharmacokinetics and a predisposition for drug-related toxicity, particularly ribavirin-induced anemia. Clinical trials of patients with chronic hepatitis C and healthy, functioning kidney grafts are rare because of the inherent dangers of graft rejection. As a result, most studies in patients with ESRD have focused on patients waiting for a kidney transplant. Additionally, because ribavirin is contraindicated in this patient population, many studies have examined monotherapy treatments. According to meta-analyses, conventional interferon alfa treatment yields a sustained virological response (SVR) rate of 37%, whereas studies of pegylated interferon alfa monotherapy have yielded SVR rates between 13% and 75%. Several small studies have also used the monitoring of ribavirin plasma concentrations or hemoglobin levels to facilitate the use of combination therapy. In light of the results from these clinical trials, we herein review treatment guidelines and recommend strategies to help optimize the treatment of patients with ESRD. Conclusion: There remains a lack of clarity surrounding the most effective treatment options for patients with chronic hepatitis C and ESRD. Treatment can be effective with many patients attaining SVR; however, unfavorable tolerability with interferon alfa-based therapy remains a concern and thus close supportive care should be aggressively pursued to help maintain adherence. (HEPATOLOGY 2008;48:1690-1699

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Preliminary Results of Treatment With Pegylated Interferon Alpha 2A for Chronic Hepatitis C Virus in Kidney Transplant Candidates on Hemodialysis

Cited by 25 publications

References 9 publications

Pegylated interferon monotherapy of chronic hepatitis C in dialysis patients: Meta‐analysis of clinical trials

Pegylated interferon monotherapy of chronic hepatitis C in dialysis patients: Meta‐analysis of clinical trials

Viral Hepatitis in Solid Organ Transplant Recipients

Treatment of chronic hepatitis C in hemodialysis patients

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