Interferon therapy in hemodialysis patients with chronic hepatitis C: study of tolerance, efficacy and post-transplantation course.
BACKGROUND
The potential benefit of pre-transplant treatment of chronic hepatitis C on long-term evolution after renal transplantation is not clear.


METHODS
Fifty successive renal transplant candidates had their sera positive for HCV RNA and a biopsy-proven chronic hepatitis. Out of these, 18 patients received a standard course of interferon-alpha2b (IFN; 3 MU three times weekly after hemodialysis sessions for 6 months).


RESULTS
IFN was discontinued in 2 patients (11%) due to persistent leukopenia. HCV RNA turned negative in 10 patients of the treatment group and in none of the control group. Two patients of the IFN group had a virological relapse post-transplantation. Post-transplant follow-up periods were 41.5 +/- 15 and 50 +/- 16 months for the treated and control groups respectively. Transaminases remained normal in all patients of the IFN group after transplantation. In contrast, biochemical evidence of acute and chronic hepatitis was observed in 5 (p = 0.03) and 13 (p = 0.002) patients, respectively, of the control group. Logistic regression analysis identified non-receiving IFN before transplantation as a risk factor for post-transplant hepatic dysfunction (odds ratio = 11.7, p = 0.003) and for chronic allograft nephropathy (odds ratio = 11.6, p = 0.02).


CONCLUSIONS
IFN-treated patients had a significantly better post-transplant hepatic function and significantly lower rates of chronic allograft nephropathy.
Mahmoud
Ihab M
IM
Department of Nephrology, Mansoura University, Mansoura, Egypt.
Sobh
Mohamed A
MA
El-Habashi
Ahmed F
AF
Sally
Samir T
ST
El-Baz
Mahmoud
M
El-Sawy
Essam
E
Ghoneim
Mohamed A
MA
D000328:Adult; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007165:Immunosuppression Therapy; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects; D008099:Liver / Q000503:physiopathology; D008297:Male; D011507:Proteinuria / Q000209:etiology; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D006435:Renal Dialysis; D014184:Transplantation, Homologous
D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins