INTERFERON THERAPY FOR CHRONIC HEPATITIS-C IN HEMODIALYSIS-PATIENTS -INCREASED SERUM LEVELS OF INTERFERON

Background/Aims: The efficacy and side effects of interferon (IFN) the rapy have not been well clarified in hemodialysis patients with chroni c hepatitis C. Methods: In 6 of 9 hemodialysis patients with chronic h epatitis C, 3 million units (MU) or 6 MU of recombinant IFN-alpha 2b o r natural IFN-alpha were administered intramuscularly daily for the fi rst 2 weeks, followed by three times a week for 22 weeks. In the remai ning 3 patients, 3 MU of IFN-alpha 2b were given three times a week fo r 24 weeks. Serum concentrations of IFN-alpha 2b were measured sequent ially after the injection of interferon. Responders were defined as th e patients with normal serum aminotransferase and negative serum HCV R NA 6 months after the cessation of IFN therapy. Results: Three of the 6 patients who were administered IFN daily in the first 2 weeks were r esponders, while the other 3 withdrew from the therapy due to serious adverse events such as depression, loss of consciousness and persisten ce of high-grade fever. Serious adverse events we:re not observed in t he 3 patients without daily administration. Half-lives of IFN-alpha 2b in hemodialysis patients were significantly longer than those in nonu remic patients (10.0 vs. 6.0 h, p < 0.05). Moreover, the areas under t he serum concentration curve of the hemodialysis patients were signifi cantly larger than those of nonuremic patients (756 +/- 223 vs. 324 +/ - 223 IU.h/ml, p < 0.05), despite the fact that the dose of IFN-alpha administered to hemodialysis patients was half that administered to no nuremic patients. Conclusions: In hemodialysis patients with chronic h epatitis C, pharmacokinetic parameters of IFN may be different from th ose in nonuremic patients, and daily or high-dose administration of IF N may lead to serious adverse events in those patients.