Efficacy and Side Effects of Interferon Alpha Treatment in Kidney Transplant Recipients with Chronic Hepatitis C

Kim, Yong Kyun; Yoon, Hye Eun; Kim, Su Hyun; Choi, Bum Soon; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew; Yang, Chul Woo; Kim, Yong Soo; Kim, Suk Young; Bang, Byung Kee

Abstract

PURPOSE: Chronic hepatitis C is a common cause of liver disease in kidney transplant (KT) recipients and lessens the chances of patients and graft survival. We evaluated the efficacy and safety of IFN- alphaatherapy in KT recipients with chronic hepatitis C. METHOD: Ten KT recipients with chronic hepatitis C treated with recombinant IFN-alpha were enrolled. All the patients had stable graft function, serum alanine aminotransferase (ALT) and positive HCV viremia were raised at the start of treatment. Eight patients received IFN alpha 3 million units three times weekly and 3 of them in combination with ribavirin in dose of 600mg daily. Two patients received pegylated INF-alphaa90 microgram once weekly.
RESULTS
In 7 patients serum ALT levels were normalized and in 6 patients HCV-RNA became negative at the end of treatment. Five patients had sustained remission (persistently negative HCV-RNA) at the end of the follow-up. One patient relapsed at 15 months after discontinuation of INF. During the course of INF therapy one patient died due to sepsis with bowel perforation. Three patients developed graft dysfunction. In all of them graft function returned with discontinuing of INF and steroid therapy. In all of three patients on INF plus ribavirin, hemolytic anemia was developed. After discontinuing of ribavirin hemolytic anemia was recovered and they were treated with INF alone.
CONCLUSION
IFN-alpha therapy results in good biochemical response and virological clearance in KT recipients with chronic hepatitis C, but in about one third of the patients, the treatment had to do stopped prematurely due to graft dysfunction.