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[Therapy with interferon plus ribavirin in hemodialysis patient with PCR-positive viral hepatitis C]
M Arambarri1, M Fernández Lucas, R Echarri
1Servicio de Nefrología, Hospital Ramón y Cajal, Madrid.
Abstract:
Traditionally, the treatment of viral hepatitis C (positive Polymerase Chain Reaction -PCR-) was with Interferon. A combination of Interferon plus Ribavirin has been producing better results in last years. Currently, Ribavirin is not indicated for patients with Chronic Kidney Disease because of a high risk of severe anaemia. In a few cases, this treatment is producing good results with previous dose adjustment. We show a case of a 28-year-old man with Chronic Kidney Disease on treatment with periodical hemodialysis and chronic hepatopathy HCV Positive RNA HCV (> 1,000,000 copies/ml) and persistent transaminase elevation. Before kidney transplantation, we decided to use Interferon (3,000,000 IU/48 hours) and Ribavirin (200 mg/24 hours) treatment. After 15 days, we saw normal transaminase values and HCV RNA was negative. The patient required temporary suspension of Ribavirin and two red blood cell transfusions due to severe anaemia. Ribavirin was reintroduced 200 mg/48 h posthemodialysis. The patient did not present any complication again, and could be treated for 14 months. After next 11 months of evolution the patient has normal rates of liver function and negative HCV RNA values.
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