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

Background and study aimsThe 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 200 mg three times weekly in chronic hepatitis C patients with chronic renal failure on haemodialysis, awaiting kidney transplantation.Patients and methodsIn 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 200 mg three times weekly. The control group included 17 chronic hepatitis C patients on haemodialysis who did not receive treatment.ResultsSixteen 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 HCV RNA. There is a statistically non-significant difference on adding ribavirin 200 mg three times weekly to pegylated interferon alfa2a.ConclusionTreatment 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.