In:
Therapeutic Apheresis and Dialysis, Wiley, Vol. 18, No. 6 ( 2014-12), p. 603-611
Abstract:
Many studies have reported poor vital prognosis in hepatitis C virus ( HCV )‐infected dialysis patients. The rate of HCV ‐infected dialysis patients in J apan is as high as 9.8%, and antiviral therapy is believed to be important for improving vital prognosis. We conducted a multicenter study to examine the administration method for pegylated interferon α‐2a ( PEG ‐ IFN α‐2a) monotherapy in HCV ‐infected dialysis. We studied 56 patients: 14 with low viral loads ( HCV RNA 〈 5.0 log IU/mL) were treated with 90 μg PEG ‐ IFN α‐2a weekly, 42 with high viral loads ( HCV RNA ≥ 5.0 log IU/mL) were treated with 135 μg PEG ‐ IFN α‐2a weekly. We examined the sustained virological response ( SVR ), factors affecting the SVR , and treatment safety. The overall SVR rate was 39% (22/56); that for genotype 1, genotype 2, low viral loads, and high viral loads was 29%, 67%, 93%, and 21%, respectively. From receiver operating characteristic ( ROC ) analysis, the HCV RNA cutoff values likely to achieve SVR for genotypes 1 and 2 were 〈 5.7 log IU/mL ( SVR rate: 64% 9/14) and 〈 6.5 log IU/mL ( SVR rate: 88% 7/8), respectively. If there was HCV RNA negativation at 4 weeks (rapid virological response), the SVR rate was 94% (16/17), whereas it was 6% (1/16) if there was HCV RNA positivity at 24 weeks. The rate of treatment discontinuation from adverse events or aggravated complications was 25% (14/56). High SVR rates can potentially be achieved with PEG ‐ IFN monotherapy by identifying the target patients, based on virus type and viral load before initiating treatment and by modifying therapy during treatment according to responsiveness.
Type of Medium:
Online Resource
ISSN:
1744-9979
,
1744-9987
DOI:
10.1111/tap.2014.18.issue-6
DOI:
10.1111/1744-9987.12189
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2010864-3
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