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Treatment of chronic hepatitis C in end stage renal disease: experience at a tertiary care centre
 
Ajay Duseja,1 Narendra S Choudhary,1 Sachin Gupta,1 Radha K Dhiman,1 Yogesh Chawla,1 Vinay Sakhuja2
Departments of Hepatology1 and
Nephrology,2
Postgraduate Institute of Medical
Education and Research,
Chandigarh - 160012, India.


Corresponding Author
: Dr. Ajay Duseja
Email: ajayduseja@yahoo.co.in


Abstract

Introduction: Treatment of patients with chronic hepatitis C (CHC) is difficult in the setting of end stage renal disease (ESRD). The present study aimed to analyze the treatment outcome in patients with CHC and ESRD, being evaluated for kidney transplantation.

Methods: Data of 65 patients of ESRD with CHC (males: 53, mean age: 39.2±14.4 years) was analysed retrospectively. Patients were treated with either pegylated or conventional interferon (IFN) without ribavirin. Treatment response was assessed for rapid virological response (RVR), early virological response (EVR), end of treatment response (ETR) and sustained virological response (SVR).

Results: All patients were receiving hemodialysis (duration 1-60 months). Sixteen patients (25%) (genotype 1: 11, genotype 3: 4, genotype 2: 1) agreed for treatment (13 pegylated IFN and 3 conventional IFN). RVR was achieved in 7 patients (44%) and out of 11 patients (69%) who achieved EVR, ETR was achieved in 7 (44%) patients. Seven patients (44%) dropped out during treatment (2 because of side effects). SVR could be demonstrated in one of 7 patients who achieved ETR (6 patients were lost to
follow up after ETR).

Conclusions: In our experience, dropouts before, during and after treatment are a major problem in patients with CHC and ESRD. Of those who complete treatment, around half of them are able to achieve the end of treatment response.