Efficacy and safety of pegylated-interferon α-2a in hemodialysis patients with chronic hepatitis C
Efficacy and safety of pegylated-interferon α-2a in hemodialysis patients with chronic hepatitis C
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DOI：
10.3748/wjg.14.255
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发表时间：
2008-01-14
影响因子：
4.3
通讯作者：
Geyik, Mehmet Faruk
中科院分区：
文献类型：
--
作者：
Ayaz, Celal;Celen, Mustafa Kemal;Geyik, Mehmet Faruk
目的：评价聚乙二醇干扰素α -2a治疗慢性丙型肝炎血液透析患者的疗效和安全性。方法：对36例慢性丙型肝炎血液透析患者进行对照和前瞻性研究。所有患者均未接受治疗，抗hcv抗体检测呈阳性，血清HCV-RNA检测呈阳性。22例患者每周接受135 μ g聚乙二醇干扰素α -2a治疗，持续48周（A组）。其余患者不予治疗，11例拒绝治疗，3例不适合肾移植，被分配到对照组（B组）。在治疗结束时评估生化和病毒学反应，并在治疗结束后24周评估持续病毒学反应（SVR）。对副作用进行了监测。结果：22例血液透析患者中，男性12例，女性10例，平均年龄35.2±12.1岁。A组有14例（82.4%）患者出现病毒学治疗末缓解，B组有1例（7.1%）患者出现病毒学治疗末缓解（P = 0.001）。A组11例（64.7%）患者出现持续病毒学应答，B组1例（7.1%）患者出现持续病毒学应答。治疗结束时，10/14例（71.4%）患者生化反应指标恢复正常。B组6例患者ALT水平最初较高，其中1例（25%）在48周结束时恢复正常。在5例（22.7%）患者中，由于虚弱、贫血和出血并发症，不得不在4月时停止治疗。结论：64.7%的慢性丙型肝炎血液透析患者接受peg -干扰素α -2a治疗可达到SVR。A组疗效明显优于B组，但需注意副作用。(c) 2008 WJG。版权所有。
AIM: To evaluate the efficacy and safety of pegylated-interferon alpha-2a in hemodialysis patients with chronic hepatitis C.METHODS: Thirty-six hemodialysis patients with chronic hepatitis C were enrolled in a controlled and prospective study. All patients were treatment naive, positive tested for anti-HCV antibodies, and positive tested for serum HCV-RNA. Twenty-two patients received 135 mu g peglyated-interferon alpha-2a weekly for 48 wk (group A). The remaining patients were left untreated, eleven refused therapy, and three were not candidates for kidney transplantation and were allocated to the control group (group B). At the end of the treatment biochemical and virological response was evaluated, and 24 wk after completetion of therapy sustained virological response (SVR) was assessed. Side effects were monitored.RESULTS: Of 22 hemodialysis patients, 12 were male and 10 female, with a mean age of 35.2 +/- 12.1 years. Virological end-of-treatment response was observed in 14 patients (82.4%) in group A and in one patient (7.1%) in group B (P = 0.001). Sustained virological response was observed in 11 patients (64.7%) in group A and in one patient in group B (7.1%). Biochemical response parameters normalized in 10/14 patients (71.4%) at the end of the treatment. ALT levels in group B were initially high in six patients and normalized in one of them (25%) at the end of the 48 wk. In five patients (22.7%) therapy had to be stopped at mo 4 due to complications of weakness, anemia, and bleeding.CONCLUSION: SVR could be achieved in 64.7% of patients on hemodialysis with chronic hepatitis C by a treatment with peglyated-interferon alpha-2a. Group A had a significantly better efficacy compared to the control group B, but the side effects need to be concerned. (c) 2008 WJG. All rights reserved.