GOALS: To determine the efficacy and safety of combination therapy in patients with hepatitis C virus (HCV) and end-stage renal disease (ESRD). BACKGROUND: There is little data on the treatment of ESRD patients with pegylated interferon and ribavirin. We designed a pilot study to determine the initial and 12-week posttreatment viral response. STUDY: A nonrandomized, prospective observational study of adjusted-dose combination therapy. Twenty patients were enrolled and began pegylated interferon at 135 microg/wk SC, and 4 weeks later ribavirin was started at 200 mg PO weekly, increasing gradually to 3 times a week for a total of 48 weeks. RESULTS: Twenty patients: M:F 18:2; mean age 52.4 years; genotype 1: 18, non-genotype 1: 2. Of the 20 patients, 5 withdrew before starting treatment. Of the 11 patients who reached 3 months, 6 had early virologic response, defined as at least a 2-log drop in their HCV count (54.5%). Of the 5 patients who were treated for 1-year, only 1 patient had a response 12 weeks after treatment. Side effects included 4 cases of anemia and 1 patient with headache. CONCLUSIONS: The initial response rate in individuals taking 3 months of treatment in our study is comparable with studies in non-ESRD patients with no serious adverse side effects. However, the sustained posttreatment rate was low. This demonstrates that combination therapy is a safe therapeutic option in the ESRD population with HCV infection which needs further testing to determine if increasing the length of treatment and/or the dose of ribavirin will affect posttreatment rates.
GOALS: To determine the efficacy and safety of combination therapy in patients with hepatitis C virus (HCV) and end-stage renal disease (ESRD). BACKGROUND: There is little data on the treatment of ESRDpatients with pegylated interferon and ribavirin. We designed a pilot study to determine the initial and 12-week posttreatment viral response. STUDY: A nonrandomized, prospective observational study of adjusted-dose combination therapy. Twenty patients were enrolled and began pegylated interferon at 135 microg/wk SC, and 4 weeks later ribavirin was started at 200 mg PO weekly, increasing gradually to 3 times a week for a total of 48 weeks. RESULTS: Twenty patients: M:F 18:2; mean age 52.4 years; genotype 1: 18, non-genotype 1: 2. Of the 20 patients, 5 withdrew before starting treatment. Of the 11 patients who reached 3 months, 6 had early virologic response, defined as at least a 2-log drop in their HCV count (54.5%). Of the 5 patients who were treated for 1-year, only 1 patient had a response 12 weeks after treatment. Side effects included 4 cases of anemia and 1 patient with headache. CONCLUSIONS: The initial response rate in individuals taking 3 months of treatment in our study is comparable with studies in non-ESRDpatients with no serious adverse side effects. However, the sustained posttreatment rate was low. This demonstrates that combination therapy is a safe therapeutic option in the ESRD population with HCV infection which needs further testing to determine if increasing the length of treatment and/or the dose of ribavirin will affect posttreatment rates.
Authors: J M Morales; M A Munoz; G Castellano; F Colina; A Fuertes; A Andres; C Campo; A Blasco; E Hernandez; J L Rodicio Journal: Transplant Proc Date: 1993-02 Impact factor: 1.066
Authors: R K Sterling; A J Sanyal; V A Luketic; R T Stravitz; A L King; A B Post; A S Mills; M J Contos; M L Shiffman Journal: Am J Gastroenterol Date: 1999-12 Impact factor: 10.864
Authors: D H Mousa; A H Abdalla; G Al-Shoail; M H Al-Sulaiman; F A Al-Hawas; A A Al-Khader Journal: Transplant Proc Date: 2004 Jul-Aug Impact factor: 1.066
Authors: Roberto J Carvalho-Filho; Ana Cristina C A Feldner; Antonio Eduardo B Silva; Maria Lucia G Ferraz Journal: World J Gastroenterol Date: 2015-01-14 Impact factor: 5.742