Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.4071
Revised: November 21, 2013
Accepted: January 3, 2014
Published online: April 14, 2014
Processing time: 215 Days and 21.1 Hours
AIM: To evaluate the efficacy and tolerability of low-dose standard or pegylated interferon (PEG-IFN) in hepatitis C virus (HCV)-positive hemodialysis patients.
METHODS: In total, 19 patients were enrolled in this study, of which 12 received PEG-IFNα-2a 67.5 μg 1 time/wk (Group 1) and 7 received standard interferon α-2b subcutaneously 1.5 × 106 U 3 times/wk (Group 2). The treatment durations were 48 wk for patients infected with HCV genotype 1 and 24 wk for patients infected with HCV genotype 2/3. All patients were prospectively followed after the completion of therapy. The efficacy and tolerability of the treatment were evaluated based on the sustained virological response (SVR) and treatment-related drop-out rate.
RESULTS: In Group 1, 11 of the 12 patients completed the treatment. Early virological response (EVR) and sustained virological response (SVR) rates were 83.3% and 91.7%, respectively. One patient withdrew from treatment due to an adverse event (leukopenia). The drop-out rate was 8.3% in this group. In Group 2, 5 of the 7 patients completed the treatment with an EVR and SVR of 85.7% and 71.4%, respectively. Two patients withdrew due to treatment-related adverse events (nausea and depression). In this group, the drop-out rate was 28.6%. In total, 16 of the patients attained EVR, and 15 of them completed the treatment. The SVR rate for the patients who attained EVR was 93.7%. Anemia was the most frequent side effect and was observed in 10/19 patients (55.5%), but could be effectively managed with erythropoietin.
CONCLUSION: Low-dose interferon monotherapy, either with PEG-IFNα-2a or standard interferon α-2b, is an effective treatment option for hemodialysis patients with chronic hepatitis C.
Core tip: The most appropriate treatment for hepatitis C virus (HCV)-positive hemodialysis patients is unknown, and the available treatments have only been assessed in a limited manner. Therefore, this study evaluated the efficacy and tolerability of treatment with low-dose standard or pegylated interferon (PEG-IFN) in HCV-positive hemodialysis patients. The results of the study indicated that low-dose interferon monotherapy, either PEG-IFNα-2a or standard interferon α-2b, is an effective treatment option for HCV-positive hemodialysis patients. Anemia was the most frequently encountered adverse event, but this could be managed with erythropoietin. These results provide important information for clinicians faced with these treatment decisions.