Categories: Hepatitis C

July 2006 Volume 2, Issue 7

Jenny Sauk, MD, Donald M. Jensen, MD, Smruti R. Mohanty, MD, Nancy Reau, MD, K. Gautham Reddy, MD, and Helen S. Te, MD

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Objectives: To evaluate the efficacy, safety and tolerability of pegylated interferon monotherapy for chronic hepatitis C virus (HCV) in patients who are on dialysis. Methods: From the University of Chicago Clinical Hepatology Database dated May 2001 to July 2005, 13 patients on dialysis with hepatitis C who have been treated with pegylated interferon were identified. Demographic and laboratory data were obtained from medical records. Patients received pegylated interferon alfa-2a at 135 µg subcutaneous (SQ) weekly (n=8) or pegylated interferon alfa-2b at 1 µg/kg SQ weekly (n=5). Side effects from the medication were noted. Results: There were 7 men and 6 women, with a mean age of 54±11 years; 11 patients (85%) were African American and 11 patients (85%) were infected with HCV genotype 1. The median serum HCV RNA level was 3,273,000 copies/mL (range, 207,000 to >40,000,000), and the median serum alanine aminotransferase level was 29 IU/mL (range, 19–77). Four patients (30%) had bridging fibrosis or cirrhosis on liver biopsy. None of the 13 patients achieved sustained virologic response; 2 patients (15%) had an undetectable viral load at the end of therapy but relapsed within 6 months of follow-up. The most common side effects were fatigue (100%), anemia defined as 2 g/dL or greater drop in hemoglobin level (60%), and psychiatric symptoms (30%). Conclusions: Pegylated interferon is ineffective for HCV infection in Conclusions Pegylated interferon is ineffective for HCV infection in patients on dialysis. Furthermore, worsening anemia, which is usually prevalent at baseline in dialysis patients, is a common adverse event even in the absence of ribavirin use.