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Published on: August 23, 2016
Interferon treatment for patients with chronic hepatitis C complicated with chronic renal failure receiving
Akira Kojima1, Satoru Kakizaki, Ken-ichi Hosonuma
1Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Insights
Hepatitis C virus (HCV) infection rates in hemodialysis patients in Gunma were 9.9%, with guideline recognition high but treatment rates low. Further education and collaboration are needed for better HCV management in dialysis patients.
Area of Science:
- Hepatology
- Nephrology
- Infectious Diseases
Background:
- The Japan Society for Dialysis Therapy established guidelines for treating Hepatitis C Virus (HCV) in dialysis patients.
- This study evaluated the current status of HCV infection and treatment among hemodialysis patients in Gunma prefecture.
Purpose of the Study:
- To assess the prevalence of HCV infection in hemodialysis patients in Gunma.
- To evaluate the awareness and implementation of national guidelines for HCV treatment in these patients.
- To analyze the treatment outcomes of pegylated interferon (peg-IFN) therapy.
Main Methods:
- A survey was conducted using questionnaires sent to all 64 hemodialysis facilities in Gunma.
- Data collected included HCV infection rates, guideline recognition, and current treatment practices.
- Pegylated interferon (peg-IFN) treatment outcomes were analyzed for 18 HCV-infected hemodialysis patients at Gunma University Hospital.
Main Results:
- The overall HCV antibody positive rate was 9.9% (256/2582 patients), with significant institutional variation (median 9.0%, range 0-40.0%).
- All surveyed institutions recognized the national guidelines, but only 37.5% were actively providing peg-IFN treatment, with others planning future implementation pending hepatologist collaboration.
- The sustained virological response (SVR) rate to peg-IFN was 33.3% overall, with lower rates observed in patients with genotype 1b/high viral load and diabetic nephropathy (P < 0.05).
Conclusions:
- Guideline awareness among hemodialysis facilities in Gunma is high.
- Despite high awareness, the utilization of pegylated interferon (peg-IFN) for HCV treatment in hemodialysis patients remains low.
- Enhanced education and improved collaboration between hemodialysis teams and hepatologists are crucial for optimizing HCV management in this population.
Background And Aims:
The Japan Society for Dialysis Therapy established "Guidelines for the Treatment of Hepatitis C Virus Infection in Dialysis Patients." We evaluated the status of HCV infection and the treatment of hemodialysis patients in Gunma prefecture.
Methods:
Questionnaires concerning the infection rate, recognition of the guidelines, and treatment status were sent to all 64 hospitals/clinics that had hemodialysis systems in Gunma prefecture. The hepatitis C virus-infected hemodialysis patients who received pegylated interferon (peg-IFN) were analyzed at Gunma University Hospital.
Results:
The positive rate for hepatitis C virus antibody was 256/2582 hemodialysis patients (9.9%). The positive rate varied between institutions (range 0-40.0%; median 9.0%). All institutes recognized the establishment of the guidelines. Conventional or peg-IFN treatment was being given at 37.5% of the institutions. The other 62.5% institutions answered that they intended to provide the treatment in the future if collaboration with a hepatologist could be arranged. The most common answers regarding the indication for IFN treatment were as follows: few complications, under 60 years of age, more than 10 years of survival expected on hemodialysis. Eighteen patients received peg-IFN treatment. The sustained virological response rate of all patients was 33.3%, 0% in 1b/high viral titer, 50% in genotype 2, and 100% in genotype 2/low viral titer. The sustained virological response rate was worse in the patients with 1b/high viral load and diabetic nephropathy (P < 0.05).
Conclusions:
Recognition of the publication of the guidelines was high. However, the number of patients treated with peg-IFN was still low. Further enlightenment and cooperation between hemodialysis teams and hepatologists are therefore needed.
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