Treatment of Hepatitis C Virus Infection in Patients with End-stage Renal Disease

Chen-Hua Liu; Jia-Horng Kao


J Gastroenterol Hepatol. 2011;26(2):228-239. 

In This Article

Treatment of ESRD Patients with HCV Infection Following RT

Antiviral therapy for HCV infection following RT is currently limited by its unsatisfactory safety and efficacy. The results of one meta-analysis, which included 102 RT recipients with chronic hepatitis C who received conventional IFN monotherapy or conventional IFN plus ribavirin therapy, showed that the overall SVR and treatment-related withdrawal rates were 18% and 35%, respectively.[168] However, many studies included in the meta-analysis did not provide clear efficacy end-points, leading to unclear SVR rates. In addition, treatment interruption was most frequently associated with acute allograft rejection, resulting in graft dysfunction or graft loss.[55,168–170] Although results with ribavirin or amantadine monotherapy, and ribavirin plus amantadine combination therapy showed improvements in serum ALT levels without detrimental effects on renal graft function, these regimens did not have any beneficial effects on viral suppression or liver histology.[171–174] Taking these lines of evidence together, IFN-based therapy should only be initiated in RT recipients under specific clinical conditions, such as fibrosing cholestatic hepatitis, when the risk of not treating HCV infection outweighs the risk of graft loss.


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