Safety and efficacy of low dose peginterferon-alpha-2a combined with Ribavirin treating chronic hepatitis C in renal transplant recipients

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Author:
MA Junjie(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
LI Guang-hui(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
XU Lu(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
ZHANG Lei(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
CHEN Zheng(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
FANG Jia-li(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
PAN Guang-hui(Department of Transplantation, Second Affiliated Hospital,Guangzhou Medical University , Guangzhou 510260, China)
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
Volume 33, Issue 09, 2012
DOI:
10.3760/cma.j.issn.0254-1785.2012.09.010
Key Word:
Kidney transplantation;Polyethylene glycols;Interferon alfa-2a;Ribavirin;Hepatitis C virus;Treatment outcome

Abstract: Objective To study the safety and efficacy of low dose Peginterferon-alpha-2a (PEG-INF-α-2a) combined with Ribavirin treating chronic hepatitis C in renal transplant recipients.Methods A total of 13 cases of HCV hepatitis were randomly divided into treatment and control groups.Seven cases in treatment group were given PEG-INF-α-2a (90 μg/week) and ribavirin (600mg/day) for 16 to 48 weeks,and the rest 6 cases in control group were subjected to general liver protection and anti-inflammatory treatment. All patients were followed up for more than 2 years.Results There were 5 cases getting early response in treatment group for 16 weeks,including four cases of complete response and no non-effects response patients. In 4 cases voluntarily receiving treatment for 48 weeks,1 case had facial muscle myalgia and increased Cr level at 35th week,humoral graft rejection was confirmed pathologically,and the treatment was terminated; 1 case had recurrence of HCV RNA replication and PEG-INF-α-2a was withdrawn at 38th week.As results,5 patients in the treatment group obtained complete response after two years,including 2 cases whose HCV-IgG had got negative,HCV RNA replication was significantly lower than in the control group,and the average Cr higher than in control group (P> 0.05). There were adverse reactions during this treatment protocol: fever,muscle myalgia,agranulocytosis, anemia and humoral graft rejection.Conclusion The efficacy of low lose PEG-INF α-2a combined with ribavirin is definite in the treatment of chronic HCV hepatitis in kidney transplant recipients.The 16-week treatment duration is reasonable.It is remarkable that PEG-INF-α-2a may cause humoral graft rejection and Cr crawling.

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