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Treatment of hepatitis C in renal transplantation candidates: a single-center experience.

Author(s): Werner T, Aqel B, Balan V, Byrne T, Carey E, Douglas D, Heilman RL, Rakela J, Mekeel K, Reddy K, Vargas HE

Affiliation(s): Division of Hepatology, Mayo Clinic Arizona, Phoenix, AZ, USA.

Publication date & source: 2010-08-27, Transplantation., 90(4):407-11.

BACKGROUND: There is no consensus on hepatitis C virus (HCV) treatment in patients with renal failure. Toxicity of pegylated interferon (PEG-IFN) and ribavirin limit options; hence the ideal approach for therapy in these patients deserves attention. We report the results of kidney transplantation (KTx) candidates infected with HCV treated with PEG-IFN monotherapy. METHODS: KTx candidates with HCV infection treated with PEG-IFN monotherapy between January 2001 and February 2009 were included. Liver biopsies were performed before therapy. Response was assessed using accepted virological time points. RESULTS: From 2636 patients listed for KTx, 60 patients were tested positive for anti-HCV. Twenty-two patients were eligible for treatment. All patients were HCV treatment naive. One patient had biopsy-confirmed cirrhosis. Mean Ishak-Knodell fibrosis stage was 1.3. Ten patients (45%) achieved sustained viral response. In genotype 1 patients, there were no relapsers among early responders, despite the limited regimen. Nine patients (40%) in the cohort have had KTx. Of these, there were four responders and five nonresponders. None of the responders have had recurrence of their HCV after their KTx. CONCLUSIONS: End-stage renal disease patients with HCV can be treated successfully with PEG-IFN monotherapy. Our sustained viral response rate was 45% (10/22) in patients treated before KTx.

Page last updated: 2010-10-05

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