Current Hepatitis Reports

, Volume 5, Issue 3, pp 101–107 | Cite as

Treatment of HCV infection in patients with renal failure

  • Suphamai Bunnapradist
  • Fabrizio Fabrizi
  • Paul Martin
Article
  • 19 Downloads

Abstract

The recent availability of effective antiviral agents offers new options in the management of chronic hepatitis C virus (HCV) infection in patients with renal failure. Interferon (IFN) can lead to excellent results in selected patients on dialysis, with long-term remission durable even after renal transplantation. Studies are under way to evaluate the efficacy of pegylated IFNs in individuals with HCV infection and renal insufficiency. Preliminary data encourage cautious ribavirin use in conjunction with IFN therapy in dialysis populations. Randomized trials are warranted, however. HCV has an important pathogenic role in cryoglobulinemia, and treatment of HCV infection may ameliorate organ damage due to cryoglobulinemia. There is no standard, effective therapy for mixed cryoglobulinemic glomerulonephritis, although IFN-alfa, with or without ribavirin, has been used successfully. The use of IFN for HCV-infected patients after renal transplantation is precluded by the high frequency of impairment of the graft, so therapy should be considered prior to transplantation.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Fabrizi F, Pozzi C, Farina M, et al.: Hepatitis C virus infection and acute or chronic glomerulonephritis: an epidemiological and clinical appraisal. Nephrol Dial Transplant 1998, 13:1991–1997.PubMedCrossRefGoogle Scholar
  2. 2.
    Finelli L, Miller JT, Tokars JI, et al.: National surveillance of dialysis-associated diseases in the United States, 2002. Semin Dial 2005, 18:52–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Qian KP, Natov SN, Pereira BJ, Lau JY: Hepatitis C virus mixed genotype infection in patients on haemodialysis. J Viral Hepat 2000, 7:153–160.PubMedCrossRefGoogle Scholar
  4. 4.
    Fabrizi F, Raffaele L, Guarnori I, et al.: Comparison of second-generation screening and confirmatory assays with recombinant antigens and synthetic peptides against antibodies to hepatitis C virus: a study in renal patients. Nephron 1995, 69:444–448.PubMedGoogle Scholar
  5. 5.
    Fabrizi F, Poordad FF, Martin P: Hepatitis C infection and the patient with end-stage renal disease. Hepatology 2002, 36:3–10.PubMedCrossRefGoogle Scholar
  6. 6.
    Marcelli D, Stannard D, Conte F, et al.: ESRD patient mortality with adjustment for comorbid conditions in Lombardy (Italy) versus the United States. Kidney Int 1996, 50:1013–1018.PubMedCrossRefGoogle Scholar
  7. 7.
    Maisonneuve P, Agodoa L, Gellert R, et al.: Cancer in patients on dialysis for end-stage renal disease: an international collaborative study. Lancet 1999, 354:93–99.PubMedCrossRefGoogle Scholar
  8. 8.
    Nakayama E, Akiba T, Marumo F, Sato C: Prognosis of anti-hepatitis C virus antibody-positive patients on regular hemodialysis therapy. J Am Soc Nephrol 2000, 11:1896–1902.PubMedGoogle Scholar
  9. 9.
    Stehman-Breen CO, Emerson S, Gretch D, Johnson RJ: Risk of death among chronic dialysis patients infected with hepatitis C virus. Am J Kidney Dis 1998, 32:629–634.PubMedGoogle Scholar
  10. 10.
    Fabrizi F, Martin P, Dixit V, et al.: Meta-analysis: effect of hepatitis C virus infection on mortality in dialysis. Aliment Pharmacol Ther 2004, 20:1271–1277. This recent article addresses the impact of HCV on mortality in patients on dialysis.PubMedCrossRefGoogle Scholar
  11. 11.
    Fabrizi F, Dulai G, Dixit V, et al.: Meta-analysis: interferon for the treatment of chronic hepatitis C in dialysis patients. Aliment Pharmacol Ther 2003, 18:1071–1081. This recent article addresses the role of interferon for HCV infection in patients on dialysis.PubMedCrossRefGoogle Scholar
  12. 12.
    Russo MW, Goldsweig CD, Jacobson IM, Brown RS Jr: Interferon monotherapy for dialysis patients with chronic hepatitis C: an analysis of the literature on efficacy and safety. Am J Gastroenterol 2003, 98:1610–1615.PubMedCrossRefGoogle Scholar
  13. 13.
    Bruchfeld A, Stahle L, Andersson J, Schvarcz R: Ribavirin treatment in dialysis patients with chronic hepatitis C virus infection—a pilot study. J Viral Hepat 2001, 8:287–292.PubMedCrossRefGoogle Scholar
  14. 14.
    Tan AC, Brouwer JT, Glue P, et al.: Safety of interferon and ribavirin therapy in haemodialysis patients with chronic hepatitis C: results of a pilot study. Nephrol Dial Transplant 2001, 16:193–195.PubMedCrossRefGoogle Scholar
  15. 15.
    Annicchiarico BE, Siciliano M: Pegylated interferon-alpha 2b monotherapy for haemodialysis patients with chronic hepatitis C [letter]. Aliment Pharmacol Ther 2004, 20:123–124.PubMedCrossRefGoogle Scholar
  16. 16.
    Sporea I, Sirli R, Golea O, et al.: Peg-interferon alfa 2a (40kDa) in patients on chronic haemodialysis with chronic C hepatitis. Preliminary results. Rom J Gastroenterol 2004, 13:99–102.PubMedGoogle Scholar
  17. 17.
    Casanovas-Taltavull T, Baliellas C, Benasco C, et al.: Efficacy of interferon for chronic hepatitis C virus-related hepatitis in kidney transplant candidates on hemodialysis: results after transplantation. Am J Gastroenterol 2001, 96:1170–1177.PubMedGoogle Scholar
  18. 18.
    Huraib S, Iqbal A, Tanimu D, Abdullah A: Sustained virological and histological response with pretransplant interferon therapy in renal transplant patients with chronic viral hepatitis C. Am J Nephrol 2001, 21:435–440.PubMedCrossRefGoogle Scholar
  19. 19.
    Campistol JM, Esforzado N, Martinez J, et al.: Efficacy and tolerance of interferon-alpha(2b) in the treatment of chronic hepatitis C virus infection in haemodialysis patients. Pre- and post-renal transplantation assessment. Nephrol Dial Transplant 1999, 14:2704–2709.PubMedCrossRefGoogle Scholar
  20. 20.
    Bunnapradist S, Fabrizi F, Vierling J, et al.: Hepatitis C therapy with long term remission after renal transplantation. Int J Artif Organs 2002, 25:1189–1193.PubMedGoogle Scholar
  21. 21.
    Fabrizi F, Martin P, Ponticelli C: Hepatitis C virus infection and renal transplantation. Am J Kidney Dis 2001, 38:919–934.PubMedGoogle Scholar
  22. 22.
    Fabrizi F, Martin P, Dixit V, et al.: Hepatitis C virus antibody status and survival after renal transplantation: meta-analysis of observational studies. Am J Transplant 2005, 5:1452–1461.PubMedCrossRefGoogle Scholar
  23. 23.
    Ozgur O, Boyacioglu S, Telatar H, Haberal M: Recombinant alpha-interferon in renal allograft recipients with chronic hepatitis C. Nephrol Dial Transplant 1995, 10:2104–2106.PubMedGoogle Scholar
  24. 24.
    Therret E, Pol S, Legendre C, et al.: Low-dose recombinant leukocyte interferon-alpha treatment of hepatitis C viral infection in renal transplant recipients. A pilot study. Transplantation 1994, 58:625–628.PubMedGoogle Scholar
  25. 25.
    Rostaing L, Izopet J, Baron E, et al.: Treatment of chronic hepatitis C with recombinant interferon alpha in kidney transplant recipients. Transplantation 1995, 59:1426–1431.PubMedGoogle Scholar
  26. 26.
    Garnier JL, Chevallier P, Dubernard JM, et al.: Treatment of hepatitis C virus infection with ribavirin in kidney transplant patients. Transplant Proc 1997, 29:783.PubMedCrossRefGoogle Scholar
  27. 27.
    Fontaine H, Vallet-Pichard A, Equi-Andrade C, et al.: Histopathologic efficacy of ribavirin monotherapy in kidney allograft recipients with chronic hepatitis C. Transplantation 2004, 78:853–857.PubMedCrossRefGoogle Scholar
  28. 28.
    Kamar N, Sandres-Saune K, Selves J, et al.: Long-term ribavirin therapy in hepatitis C virus-positive renal transplant patients: effects on renal function and liver histology. Am J Kidney Dis 2003, 42:184–192. This article addresses the long-term use of ribavirin in renal transplant recipients with hepatitis C.PubMedCrossRefGoogle Scholar
  29. 29.
    Shu KH, Lan JL, Wu MJ, et al.: Ultralow-dose alphainterferon plus ribavirin for the treatment of active hepatitis C in renal transplant recipients. Transplantation 2004, 77:1894–1896.PubMedCrossRefGoogle Scholar
  30. 30.
    Tang S, Cheng IK, Leung VK, et al.: Successful treatment of hepatitis C after kidney transplantation with combined interferon alpha-2b and ribavirin. J Hepatol 2003, 39:875–878.PubMedCrossRefGoogle Scholar
  31. 31.
    Kamar N, Rostaing L, Sandres-Saune K, et al.: Amantadine therapy in renal transplant patients with hepatitis C virus infection. J Clin Virol 2004, 30:110–114.PubMedCrossRefGoogle Scholar
  32. 32.
    Misiani R, Bellavita P, Fenili D, et al.: Interferon alfa-2a therapy in cryoglobulinemia associated with hepatitis C virus. N Engl J Med 1994, 330:751–756.PubMedCrossRefGoogle Scholar
  33. 33.
    Johnson RJ, Gretch DR, Couser WG, et al.: Hepatitis C virus-associated glomerulonephritis. Effect of alpha-interferon therapy. Kidney Int 1994, 46:1700–1704.PubMedCrossRefGoogle Scholar
  34. 34.
    Rossi P, Bertani T, Baio P, et al.: Hepatitis C virus-related cryoglobulinemic glomerulonephritis: long-term remission after antiviral therapy. Kidney Int 2003, 63:2236–2241.PubMedCrossRefGoogle Scholar
  35. 35.
    Garini G, Allegri L, Carnevali L, et al.: Interferon-alpha in combination with ribavirin as initial treatment for hepatitis C virus-associated cryoglobulinemic membranoproliferative glomerulonephritis [case report]. Am J Kidney Dis 2001, 38:E35.PubMedGoogle Scholar
  36. 36.
    Koenig P, Vogel W, Umlauft F, et al.: Interferon treatment for chronic hepatitis C virus infection in uremic patients. Kidney Int 1994, 45:1507–1509.PubMedCrossRefGoogle Scholar
  37. 37.
    Pol S, Thiers V, Carnot F, et al.: Efficacy and tolerance of alpha-2b interferon therapy on HCV infection of hemodialyzed patients. Kidney Int 1995, 47:1412–1418.PubMedCrossRefGoogle Scholar
  38. 38.
    Raptopoulou-Gigi M, Spaia S, Garifallos A, et al.: Interferon-alpha 2b treatment of chronic hepatitis C in haemodialysis patients. Nephrol Dial Transplant 1995, 10:1834–1837.PubMedGoogle Scholar
  39. 39.
    Fernandez JL, Rendo P, del Pino N, Viola L: A double-blind controlled trial of recombinant interferon-alpha 2b in haemodialysis patients with chronic hepatitis C virus infection and abnormal aminotransferase levels. Nephrologists’ Group for the Study of HCV Infection. J Viral Hepat 1997, 4:113–119.PubMedGoogle Scholar
  40. 40.
    Izopet J, Rostaing L, Moussion F, et al.: High rate of hepatitis C virus clearance in hemodialysis patients after interferon-alpha therapy. J Infect Dis 1997, 176:1614–1617.PubMedCrossRefGoogle Scholar
  41. 41.
    Chan TM, Wu PC, Lau JY, et al.: Interferon treatment for hepatitis C virus infection in patients on haemodialysis. Nephrol Dial Transplant 1997, 12:1414–1419.PubMedCrossRefGoogle Scholar
  42. 42.
    Uchihara M, Izumi N, Sakai Y, et al.: Interferon therapy for chronic hepatitis C in hemodialysis patients: increased serum levels of interferon. Nephron 1998, 80:51–56.PubMedCrossRefGoogle Scholar
  43. 43.
    Benci A, Caremani M, Menchetti D, et al.: Low-dose leukocyte interferon-alpha therapy in dialysed patients with chronic hepatitis C. Curr Med Res Opin 1998, 14:141–144.PubMedCrossRefGoogle Scholar
  44. 44.
    Espinosa M, Rodriguez M, Martin-Malo A, et al.: Interferon therapy in hemodialysis patients with chronic hepatitis C virus infection induces a high rate of long-term sustained virological and biochemical response. Clin Nephrol 2001, 55:220–226.PubMedGoogle Scholar
  45. 45.
    Hanrotel C, Toupance O, Lavaud S, et al.: Virological and histological responses to one year alpha-interferon-2a in hemodialyzed patients with chronic hepatitis C. Nephron 2001, 88:120–126.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2006

Authors and Affiliations

  • Suphamai Bunnapradist
    • 1
  • Fabrizio Fabrizi
  • Paul Martin
  1. 1.Department of Medicine, Division of Nephrology, Kidney and Pancreas Transplant Research OfficeDavid Geffen School of MedicineLos AngelesUSA

Personalised recommendations