Chronic hepatitis C genotype 4 treatment in chronic haemodialysis patients: A retrospective study

Abstract 

Background and study aims

The necessity to treat patients with chronic hepatitis C virus infection (HCV) prior to renal transplantation is evident, particularly in young non-cirrhotic patients. In this study our aim was to asses the virological response to pegylated interferon alone and in combination with ribavirin 200mg three times weekly in chronic hepatitis C patients with chronic renal failure on haemodialysis, awaiting kidney transplantation.

Patients and methods

In a retrospective study, data of patients from King Saud Medical Complex in Saudi Arabia were collected. Three groups were included: Group1 included 18 chronic hepatitis C patients with chronic renal failure on haemodialysis who received pegylated interferon alfa2a. Group 2 included 19 chroinc hepatitis C patients who received pegylated interferon alfa2a with ribavirin 200mg three times weekly. The control group included 17 chronic hepatitis C patients on haemodialysis who did not receive treatment.

Results

Sixteen patients in each Groups 1 (89%) and 2 (84%) tolerated treatment and continued therapy. Out of these, 56% of Group 1 patients showed a sustained virological response (SVR), whereas in Group 2 75% had a SVR. Non of Group 3 patients had negative HCVRNA. There is a statistically non-significant difference on adding ribavirin 200mg three times weekly to pegylated interferon alfa2a.

Conclusion

Treatment of chronic hepatitis C in haemodialysis patients is generally safe and well tolerated. A significant SVR can be obtained either in the pegylated interferon alone or in combination with low dose ribavirin. We recommend larger prospective controlled clinical trials especially in haemodialysis patients eligible for kidney transplantation and a follow-up on patients after kidney transplantation to assess outcome.

Keywords: Hepatitis C virus, Genotype 4, Pegylated interferon, Ribavirin, Haemodialysis