title: Is early virological response as predictive of the hepatitis C treatment response in dialysis patients as in non-uremic patients?
abstract: OBJECTIVE
  The aim of the present study was to determine whether hepatitis C virus (HCV) RNA present at week 12 is a good predictor of the response to interferon (IFN) monotherapy in hemodialysis patients with hepatitis C.
  
  
  METHODS
  Hemodialysis patients with hepatitis C who were treated between 1997 and 2008 with IFN monotherapy for 48 weeks without dose reduction were included. The predictive value of HCV RNA at week 12 for achieving a sustained virological response (SVR) was determined.
  
  
  RESULTS
  Forty patients (mean age 47±9 years; 75% males and 80% with genotype 1) were included. Septal fibrosis or cirrhosis was observed in 38% of these patients. Twelve (30%) of the 40 patients achieved SVR. HCV RNA was undetectable at week 12 in 68%. The positive predictive value of HCV RNA at week 12 was 45% and the negative predictive value was 100%.
  
  
  CONCLUSIONS
  The presence of HCV RNA at week 12 had a high negative predictive value for SVR in hemodialysis patients with chronic hepatitis C treated with IFN for 48 weeks. Therefore, if HCV RNA is detected at week 12, treatment should be discontinued due to the low probability of a sustained response.
authors.affiliation: Division of Gastroenterology, Hepatitis Section, Federal University of São Paulo, São Paulo, Brazil. patriciafucuta@gmail.com
authors.forename: Patricia da Silva
authors.initials: Pda S
authors.lastname: Fucuta Pereira
authors.forename: Silvia Naomi de Oliveira
authors.initials: SN
authors.lastname: Uehara
authors.forename: Renata
authors.initials: R
authors.lastname: de Mello Perez
authors.forename: Ana Cristina Amaral
authors.initials: AC
authors.lastname: Feldner
authors.forename: Isaura Cunha
authors.initials: IC
authors.lastname: de Melo
authors.forename: Ivonete Sandra
authors.initials: IS
authors.lastname: de Souza e Silva
authors.forename: Antonio Eduardo Benedito
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia Gomes
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001938:Brazil; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons