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Relevance of low viral load in haemodialysed patients with chronic hepatitis C virus infection

World Journal of Gastroenterology 2015年第18期21卷 5496-5504页

作者： Jan Sperl sona frankova Renata Senkerikova Magdalena Neroldova Vaclav Hejda Miroslava Volfova Dusan Merta Ondrej Viklicky Julius Spicak Milan Jirsa Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Laboratory of Experimental Hepatology Institute for Clinical and Experimental Medicine Department of Internal Medicine Division of Gastroenterology and Hepatology Charles University Medical School and Teaching Hospital Hepato-gastroenterology 50012 Hradec Kralove Czech Republic Department of Anesthesiology Resuscitation and Intensive Care Institute for Clinical and Experimental Medicine Department of Nephrology Institute for Clinical and Experimental Medicine

AIM: To identify predictors of sustained virological response in hemodialysed patients treated by PEGinterferon α for chronic hepatitis C, genotype ***: The sustained virological response(SVR) rate, IL28 B genotype, IFNL4 genotype, initial viral load(IVL) and other pretreatment variables in 39 endstage 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 nave and had well compensated liver disease. The ESRD patients received 135 μg of PEGylated interferon α-2a(Peg IFN-α) weekly and a reduced dose of ribavirin(RBV) was administered to 23/39 patients with an initial haemoglobin level > 10 g/d L. Control group patients were given standard doses of Peg IFN-α 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 χ2 testcompared the *** regression was used to determine significant predictors of *** values for continuous variables were obtained from Receiver Operating Characteristic ***:The distribution of IL28B rs12979860 CC,CT and TT genotypes in the ESRD group was 28.2%,64.1%and 7.7%,respectively,and 19.3%,62.4%and18.3%in the *** IFNL4 genotype was in almost absolute linkage disequlibrium with *** proportion of patients with a low IVL(<600000 IU/m L)was significantly higher in the ESRD group than in the controls(28/39,71.8%vs 51/109,46.8%,P=0.009),as was the proportion of patients with low IVL in IL28B CC carriers compared with non-CC carriers in the ESRD group(10/11,90.9%vs 18/28,64.3%,P=0.0035).This difference was not found in the controls(7/22,31.8%vs 44/87,50.6%,P=0.9).The overall SVR rate was 64.1%(25/39)in the ESRD group and 50.5%(55/109)in the control group(P=0.19).11/11(100%)and 19/22(86.4%)IL28B CC patients achieved SVR in the

关键词： End-stage renal disease Hepatitis C virus genotype 1 Interferon alpha IFNL4 Ribavirin

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