Interferon-alpha in chronic hepatitis C infection in dialysis patients

This study assesses the efficacy and adverse effects of interferon-alpha (I FN-alpha) administered at a dosage of 3 million units three times weekly fo r 1 year in 17 hemodialysis patients with hepatitic C virus (HCV)-associate d chronic hepatitis (biopsy proven), The patients were prospectively follow ed up for a period of 18 months, Liver biopsy was repeated after 6 months o f treatment in 13 patients. Patients were classified according to the histo logical activity index. Biochemical and virological responses were evaluate d at the end (end-of-treatment response) and 6 months after completion of t herapy (sustained response), HCV RNA became negative in 76% of the patients after 12 weeks of treatment, in 88% after 12 months of treatment, and in 7 1% of the patients 6 months after completion of therapy, HCV genotype 4 was found in 60% of our population. Alanine aminotransferase (ALT) levels were initially increased in only 6 patients and normalized in 4 of these patien ts after 12 weeks of therapy, with end-of-treatment and sustained biochemic al responses of 83% and 67%, respectively. Of 13 patients who underwent liv er biopsies after 6 months of therapy, 11 patients (85%) showed histologica l improvement, One patient could not tolerate therapy because of marked let hargy and myalgia; the other patients had minor side effects that did not r equire discontinuation of treatment. Two patients received a cadaveric rena l transplant after 1 year of IFN treatment, and they continued to maintain biochemical and virological responses after a follow-up of 17 and 28 months , respectively, (C) 1999 by the National Kidney Foundation, Inc.