Interferon-alpha therapy within the first year after acute hepatitis C infection in hemodialysis patients: efficacy and tolerance.
BACKGROUND
Interferon monotherapy significantly reduces the chronicity rate of acute hepatitis C in nonuremic patients. In this clinical study, we evaluated the efficacy and tolerance of interferon-alpha therapy for acute hepatitis C in hemodialysis patients.


METHODS
Patients with acute hepatitis C, established on the basis of seroconversion to anti-hepatitis C virus and the presence of hepatitis C virus RNA, received a low dose of interferon-alpha (3 MU three times per week) for 12 months or a high dose (5 MU three times per week, preceded by a daily induction dose) for 6 months. Response to treatment was defined as undetectable hepatitis C virus RNA at the end of treatment and sustained virological response was defined as persistent negative hepatitis C virus RNA 6 months after the end of treatment.


RESULTS
Twenty-three patients were treated, 16 with a low dose of interferon-alpha and seven with a high dose. At the end of treatment, hepatitis C virus RNA was undetectable in 16/23 patients (70%). Of these, 6/23 patients (26%) relapsed and 10/23 (43%) maintained a sustained virological response (38% in lower doses vs. 57% in higher doses). Treatment was well tolerated and only three patients discontinued therapy (13%).


CONCLUSIONS
Interferon-alpha within the first year after acute hepatitis C in hemodialysis patients was found to be safe and effective, inducing a sustained virological response in 43% of cases. This study supports the routine indication of acute hepatitis C treatment with interferon-alpha for hemodialysis patients, and higher doses administered for a shorter period of time should be tried according to the tolerance of the patients.
Rocha
Cristina M
CM
Division of Gastroenterology, Federal University of São Paulo, São Paulo, Brazil.
Perez
Renata M
RM
Narciso
Janaína L
JL
Ferreira
Adalgisa P
AP
Lemos
Lara B
LB
Medina-Pestana
José O
JO
Silva
Antonio Eduardo B
AE
Ferraz
Maria Lucia G
ML
D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000517:prevention & control; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral