title: Lack of Efficacy of Pegylated Interferon Monotherapy for Hepatitis C in Patients With End-Stage Renal Disease on Dialysis.
abstract: ObjectivesTo evaluate the efficacy, safety and tolerability of pegylated interferon monotherapy for chronic hepatitis C virus (HCV) in patients who are on dialysis.MethodsFrom the University of Chicago Clinical Hepatology Database dated May 2001 to July 2005, 13 patients on dialysis with hepatitis C who have been treated with pegylated interferon were identified. Demographic and laboratory data were obtained from medical records. Patients received pegylated interferon alfa-2a at 135 µg subcutaneous (SQ) weekly (n = 8) or pegylated interferon alfa-2b at 1 µg/kg SQ weekly (n = 5). Side effects from the medication were noted.ResultsThere were 7 men and 6 women, with a mean age of 54±11 years; 11 patients (85%) were African American and 11 patients (85%) were infected with HCV genotype 1. The median serum HCV RNA level was 3,273,000 copies/mL (range, 207,000 to >40,000,000), and the median serum alanine aminotransferase level was 29 IU/mL (range, 19-77). Four patients (30%) had bridging fibrosis or cirrhosis on liver biopsy. None of the 13 patients achieved sustained virologic response; 2 patients (15%) had an undetectable viral load at the end of therapy but relapsed within 6 months of follow-up. The most common side effects were fatigue (100%), anemia defined as 2 g/dL or greater drop in hemoglobin level (60%), and psychiatric symptoms (30%).ConclusionsPegylated interferon is ineffective for HCV infection in patients on dialysis. Furthermore, worsening anemia, which is usually prevalent at baseline in dialysis patients, is a common adverse event even in the absence of ribavirin use.
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: Jenny
authors.initials: J
authors.lastname: Sauk
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Jensen
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: Smruti R
authors.initials: SR
authors.lastname: Mohanty
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: Nancy
authors.initials: N
authors.lastname: Reau
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: K Gautham
authors.initials: KG
authors.lastname: Reddy
authors.affiliation: Dr. Sauk is a medical resident in the Department of Medicine; Dr. Jensen is Professor of Medicine and Drs. Mohanty, Reau, Reddy, and Te are Assistant Professors of Medicine at the Center for Liver Diseases, Section of Gastroenterology, all at the University of Chicago in Illinois.
authors.forename: Helen S
authors.initials: HS
authors.lastname: Te
keywords: Hepatitis C; dialysis; end-stage; pegylated interferon; renal disease; renal failure