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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Therapeutic Aspects of Hepatitis C in Hemodialysis Patients

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          Abstract

          Background: Since hemodialysis (HD) patients usually suffer from multiple clinical problems and drug side effects, the treatment of hepatitis C in these patients still remains a challenging problem. Methods: We identified eligible studies using a wide-spectrum search up to May 2007 in MEDLINE (since 1966) and EMBASE (since 1980). Two researchers (S.M.H.M. and M.R.) independently reviewed the manuscripts identified by the search strategy. To determine the most current information, only studies that had been published after 1995 were included. Results: Interferon (IFN)-α has long been used for this purpose; however, more recently the advent of pegylated (PEG) IFN has proven to be more beneficial in these patients. Even though the usage of ribavirin is promising in the case of hepatitis C in otherwise healthy subjects, the utilization of this drug in patients with renal failure may be accompanied by catastrophic complications. Conclusion: Although both conventional IFN and PEG-IFN seem to be favorable options for the management of hepatitis C in HD patients, further studies on new therapeutic agents are required.

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          Diagnosis, management, and treatment of hepatitis C.

          Doris B Strader, Teresa Wright, David Thomas … (2004)
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            Randomised trial of interferon α2b plus ribavirin for 48 weeks or for 24 weeks versus interferon α2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus

            Thierry Poynard, Patrick Marcellin, Samuel S. Lee … (1998)
            Article 0 comments Cited 95 times – based on 0 reviews     Review now
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              Evidence that clearance of hepatitis C virus RNA after alpha-interferon therapy in dialysis patients is sustained after renal transplantation.

              Karine Saune, Nassim Kamar, Jacques Izopet … (2003)
              To date, there is no available treatment of hepatitis C virus (HCV) infection after renal transplantation (RT). Among 55 anti-HCV-positive/HCV RNA-positive hemodialysis patients who were treated with IFN-alpha (9 MU/wk during 6 or 12 mo), 21 of them (38%) had a sustained virologic response. Of these, 16 (76%) underwent RT 38 mo (range, 2 to 57 mo) after alpha-IFN therapy. There were 13 men and 3 women aged 46 yr (range, 27 to 68 yr). At RT, HCV serology was still positive in 15 patients, and HCV viremia was negative in all patients. Immunosuppression relied on anticalcineurin agents with or without steroids and/or antimetabolites; in addition, 12 of them received induction therapy with antithymocyte globulins. At the last follow-up after RT, at 22.5 mo (range, 2 to 88 mo), HCV viremia remained negative in all patients. Moreover, HCV RNA was not present in peripheral blood mononuclear cells when assessed in eight patients. HCV serology was found to be still positive in 13 patients. Three patients presented with acute rejection, one presented with a suppurative lymphocele, one died from a sepsis, and four presented with a cytomegalovirus infection. None of them developed posttransplant diabetes mellitus. In conclusion, hemodialysis patients waiting for a RT need to be treated with alpha-IFN because when HCV RNA clearance occurred, they experienced no relapse after transplantation despite chronic immunosuppressive treatment.
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                Author and article information

                Journal
                Journal ID (publisher-id): AJN
                Journal ID (nlm-ta): Am J Nephrol
                Journal ID (doi): 10.1159/issn.0250-8095
                Title: American Journal of Nephrology
                Publisher: S. Karger AG
                ISSN (Print): 0250-8095
                ISSN (Electronic): 1421-9670
                Publication date Subscription-year: 2009
                Publication date (Print): January 2009
                Publication date (Electronic): 22 August 2008
                Volume: 29
                Issue: 2
                Pages: 123-128
                Affiliations
                aUrology and Nephrology Research Center (UNRC), Shahid Beheshti University, M.C. (SBUMS), and bBaqiyatallah Research Center for Gastroenterology and Hepatology, UNRC, Baqiyatallah University of Medical Sciences, Tehran, Iran
                Article
                Publisher ID: 151633 Other ID: Am J Nephrol 2009;29:123–128
                DOI: 10.1159/000151633
                PubMed ID: 18719345
                SO-VID: 10e3adac-1281-45b7-8cda-c20dfff6d129
                Copyright © © 2008 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 24 April 2008
                Date accepted : 11 June 2008
                Page count
                Tables: 1, References: 49, Pages: 6
                Categories
                Subject: Original Report: Patient-Oriented, Translational Research

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Hepatitis C virus,Kidney failure,Dialysis
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Hepatitis C virus, Kidney failure, Dialysis

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