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Background/Aims:   Hepatitis C virus infection remains prevalent among patients undergoing long-term haemodialysis and has a detrimental impact on survival in this population. Antiviral therapy for chronic hepatitis C in haemodialysis patients is still a challenge to clinicians. The aim of the current study is to evaluate the efficacy and safety of therapy with pegylated interferon, alone or combined with ribavirin, for chronic hepatitis C among patients undergoing long-term hemodialysis.   Methods:   We conducted a retrospective, multicenter cohort trial with monotherapy (pegylated interferon) ( n =21) or combined antiviral therapy (pegylated interferon plus ribavirin) ( n =5) for chronic hepatitis C in patients undergoing long-term haemodialysis.   Results:   Sustained virological response was obtained in eleven (42%) patients. Seven (26.9%) patients interrupted prematurely the antiviral treatment due to serious side-effects, the most frequent cause of treatment withdrawal being hematological ( n =3). HCV RNA load was lower in responder than non-responder patients, 5.44 (3.45; 6.36)  vs . 5.86 (4.61; 6.46) log<sub>10</sub> copies/mL, even if the difference was not significant ( P =0.099). Blood transfusion requirement was greater in patients on combined antiviral therapy than those on pegylated interferon alone, 100% (5/5)  vs . 0% (0/21),  P =0.0001. No difference in sustained viral response occurred between patients on combined antiviral therapy and those on pegylated interferon monotherapy [40% (2/5)  vs . 42.8% (9/21),  P =0.90].   Conclusions:   Results from this study showed that pegylated interferon alone or with ribavirin is unsatisfactory in terms of efficacy and safety. Prospective trials based on interferon-free regimens (i.e., sofosbuvir plus ribavirin or sofosbuvir plus daclatasvir) are under way in patients with hepatitis C receiving long-term hemodialysis.

Pegylated Interferon (Alone or With Ribavirin) for Chronic Hepatitis C in Haemodialysis Population