Pegylated interferon for the treatment of hepatitis C virus in haemodialysis patients

Abstract

In patients undergoing maintenance haemodialysis, hepatitis C virus (HCV) infection is common and may lead to severe complications such as chronic hepatitis, cirrhosis and hepatocellular carcinoma. It is recommended to eradicate HCV infection in dialysis patients awaiting renal transplantation and those with acute hepatitis C or significant chronic liver disease. Interferon-a-2a in monotherapy thrice weekly, which is the standard treatment for HCV infection in this setting, has many drawbacks such as poor tolerance and marginal response [1]. The addition of ribavirin is generally contra-indicated in these patients due to a risk of haemolytic anaemia. Pegylated interferon was developed by attaching a large polyethylene glycol (PEG) moiety (40 kDa) to interferon in order to confer greater stability and prolonged systemic exposure to allow once-weekly administration [2]. In two randomized controlled trials, PEG–interferon-a-2a in monotherapy was more efficient than conventional interferon for the treatment of HCV infection associated with chronic liver disease [3,4]. Currently, there is no published experience concerning the use of this compound in patients with end-stage renal disease (ESRD).