HCV RNA CLEARANCE BY HEMODIALYSIS-PATIENT S WITH AND WITHOUT HGV HGBV-C INFECTION AFTER ALPHA-INTERFERON-THERAPY/

Patients on maintenance hemodialysis are frequently infected with hepa titis C virus (HCV). The long-term effect of alpha interferon therapy has not yet been assessed, or the influence of co-infection with the n ewly discovered hepatitis G/hepatitis GB virus-C (HGV/HGBV-C) upon the rapy outcome. Eleven anti-HCV and HCV RNA-positive hemodialysis patien ts, 3 of whom had HGV/HGBV-C infection were given 3 mega-units of alph a 2b recombinant interferon subcutaneously 3 times weekly for six mont hs. The mean follow-up after cessation of therapy was 24 +/- 8 months (range: 18-30 months). Sustained serum HCV RNA clearance, as assessed by PCR analysis, occurred in 5/11 patients (45.5%). Two had received a cadaveric kidney transplant at 16 and 18 months post-treatment and we re treated by immunosuppressive therapy; HCV RNA remained undetectable in both serum and a liver biopsy. HCV was eradicated in 3 of the 6 pa tients infected with HCV genotype Ib, which is less sensitive to alpha -interferon than other HCV genotypes. Among the 3 patients infected wi th both HCV and HGV/HGBV-C, alpha-interferon cleared the HCV RNA from one patient, but not the HGV/HGBV-C RNA. In view of the high rate of H CV eradication after alpha-interferon therapy and its fair tolerance, we suggest that HCV RNA-positive dialysis patients should be treated b efore transplantation, regardless of their aminotransferase levels or liver histological score, since alpha interferon therapy after renal a llografting is associated with an unacceptable rate of renal failure. Our preliminary data indicate that HGV/HGBV-C does not interfere with sustained HCV RNA clearance.