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Multicenter Study of Pegylated Interferon α‐2a Monotherapy for Hepatitis C Virus‐Infected Patients on Hemodialysis: REACH Study
Author(s) -
Kikuchi Kan,
Akiba Takashi,
Nitta Kosaku,
Masakane Ikuto,
Ando Ryoichi,
Izumi Namiki,
Atsukawa Masanori,
Yamazaki Chikao,
Kato Fumi,
Hotta Naoki,
Tominaga Yoshihiro,
Orito Etsuro,
Hora Kazuhiko,
Nagasawa Masaki,
Kasahara Hiroshi,
Kawaguchi Masanori,
Kimura Hiroyuki,
Ikebe Norisato,
Kawanishi Hideki,
Moriishi Misaki,
Shigemoto Kenichiro,
Harada Takashi,
Hirakata Hideki,
Watanabe Hiroshi,
Nosaki Tsuyoshi,
Tsubouchi Hirohito,
Imawari Michio,
Akizawa Tadao
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12189
Subject(s) - medicine , pegylated interferon , hemodialysis , multicenter study , virology , hepatitis a virus , interferon , hepatitis c virus , gastroenterology , virus , ribavirin , randomized controlled trial
Many studies have reported poor vital prognosis in hepatitis C virus ( HCV )‐infected dialysis patients. The rate of HCV ‐infected dialysis patients in J apan is as high as 9.8%, and antiviral therapy is believed to be important for improving vital prognosis. We conducted a multicenter study to examine the administration method for pegylated interferon α‐2a ( PEG ‐ IFN α‐2a) monotherapy in HCV ‐infected dialysis. We studied 56 patients: 14 with low viral loads ( HCV RNA < 5.0 log IU/mL) were treated with 90 μg PEG ‐ IFN α‐2a weekly, 42 with high viral loads ( HCV RNA ≥ 5.0 log IU/mL) were treated with 135 μg PEG ‐ IFN α‐2a weekly. We examined the sustained virological response ( SVR ), factors affecting the SVR , and treatment safety. The overall SVR rate was 39% (22/56); that for genotype 1, genotype 2, low viral loads, and high viral loads was 29%, 67%, 93%, and 21%, respectively. From receiver operating characteristic ( ROC ) analysis, the HCV RNA cutoff values likely to achieve SVR for genotypes 1 and 2 were <5.7 log IU/mL ( SVR rate: 64% 9/14) and <6.5 log IU/mL ( SVR rate: 88% 7/8), respectively. If there was HCV RNA negativation at 4 weeks (rapid virological response), the SVR rate was 94% (16/17), whereas it was 6% (1/16) if there was HCV RNA positivity at 24 weeks. The rate of treatment discontinuation from adverse events or aggravated complications was 25% (14/56). High SVR rates can potentially be achieved with PEG ‐ IFN monotherapy by identifying the target patients, based on virus type and viral load before initiating treatment and by modifying therapy during treatment according to responsiveness.