Abstract
AIM: To identify predictors of sustained virological response in hemodialysed patients treated by PEGinterferon alpha for chronic hepatitis C, genotype 1. METHODS: The sustained virological response (SVR) rate, IL28B genotype, IFNL4 genotype, initial viral load (IVL) and other pretreatment variables in 39 end-stage renal disease patients (ESRD) on maintenance haemodialysis (HD) infected with hepatitis C virus (HCV), genotype 1b, were compared with a control group of 109 patients with normal kidney function treated within the same period.
All the patients were treatment naive and had well compensated liver disease. The ESRD patients received 135 mu g of PEGylated interferon alpha-2a (PegIFN-alpha) weekly and a reduced dose of ribavirin (RBV) was administered to 23/39 patients with an initial haemoglobin level > 10 g/dL.
Control group patients were given standard doses of PegIFN-alpha and RBV. SVR was assessed as hcv RNA negativity 24 wk post-treatment.
A t-test or ANOVA were used for comparisons of the means and a chi(2) testcompared the frequencies. Logistic regression was used to determine significant predictors of SVR.
Cutoff values for continuous variables were obtained from Receiver Operating Characteristic analysis. CONCLUSION: Haemodialysis decreases the viral load, especially in IL28B CC genotype carriers.
A low IVL was the strongest predictor of SVR in ESRD patients identified in multivariate analysis.