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Efficacy and safety of treatment of hepatitis C virus infection in renal transplant recipients

World Journal of Gastroenterology 2012年第1期18卷 55-63页

作者： Abdulrahman A aljumah Mohamed A Saeed Ahmed I al Flaiw ibrahim h al traif Abduljaleel M al alwan Salem h al Qurashi Ghormallah A al Ghamdi Fayez F al hejaili Mohammed A al Balwi Abdulla A al Sayyari Division of hepatology Department of Hepatobiliary Sciences and Liver Transplantation King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences National Guard Health Affairs Division of Nephrology and Renal Transplantation Department of Medicine King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences National Guard Health Affairs Division of Molecular Pathology and Genetics King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences National Guard Health Affairs

AIM: To assess the efficacy and safety of combinedpegylated interferon and ribavirin therapy in hepatitis C virus (hCV) infection in renal transplant recipients. METhODS: This is a retrospective chart review of post renal transplant patients who were positive for anti-hCV and hCV-RNA, and who have received treatment with combination of pegylated interferon and ribavirin between October 2003 and December 2008. Only patients with stable graft function and absence of evidence of cirrhosis and who received the therapy for continuous 48 wk were included. Nineteen patients (13 male and 6 female) were identified and included. The patient's complete blood count, liver and kidney prof ile, and cal- culated glomerular f iltration rate (GFR) were monitored every 6-8 wk while on treatment. hCV-RNA was tested at 12 wk for early virological response, at 48 wk for end of treatment response (ETR), and then retested at 24, and 48 wk after completion of therapy for sustained virological response (SVR). Liver biopsies were obtained before treatment from all patients and graft kidney biopsies were performed as required. RESULTS: Of the entire cohort, 9 patients (47.4%) showed an ETR and 8 had SVR (42.1%). Of the 8 patients with abnormal alanine aminotransferase (alT) levels at baseline, 78.9% had their alT normalized (including the virological non responders). alT was normal in all responders at the end of therapy and at 24 wk post therapy (100%). Only one patient (5.3%) developed an increase in creatinine and decline in GFR from baseline towards the end of treatment. This patient's kidney biopsy revealed borderline rejection. There was no impact on response by hCV-genotype, initial hCV RNA load, age or sex of the patient or duration post transplant before commencement of therapy. all patients tolerated treatment in the same way as non-transplant with no unusual or increased occurrence of side effects. CONCLUSION: The combination of pegylated interferon and ribavirin is effective in su

关键词： allograft rejection hepatitis C Pegylated interferon Ribavirin Renal transplant

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