Interferon α-2a Treatment of Chronic Hepatitis C in Hemodialysis (HD) Patients

使用干擾素治療血液透析病人慢性C型肝炎之療效報告

陳良根(L. K. Chen) ； 劉宏祥(H. H. Liou) ； 劉美琴(M. C. Liu) ； 胡淑慧(S. H. Hu) ； 盧嘉慧(C. H. Lu)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 299-299

並列摘要

Hepatitis C virus (HVC) infection is the most common cause of chronic liver disease in hemodialysis (HD) patients. According to the annual report of T.S.N. in 1997, the prevalence rate of HCV infection in HD patients was 31.4%. Recent studies have shown that HCV may increase the risk fro death in the HD population. We conducted a study to exam the tolerance & efficacy of interferon α-2a (IFN-α,Roferon®-A) therapy on HCV infection in HD patient. Thirteen HD patients with chronic hepatitis C were treated with IFN-α at a dose of 3 MU trice weekly for 3 (Gr A, n=11), 6(Gr B, n=9), or 12 months (Gr C, n=3). They were followed-up for another 6 (Gr B) or 9months (Gr A) after cessation of treatment. Two patients discontinued IFN-α treatment due to the intolerable side effects. At end of treatment, HCV RNA became negative in 45.5% (5/11) of patients after 3 months, 77.8% (7/9) after 6 months, & 66.7% (2/3) after 12 months of IFN-α treatment. Inaddition, the HCV titers after IFN-α treatment were decreased by 91.6%, 94.9% &99.9% in A,B, & C group of patients, respectively. HCV RNA remained negative in 40% (Gr B, 2/5) patients after 6 months of follow-up. Serum ALT & AST levels were within normal limits at the beginning of the study in all patients except one who had a elevated ALT & AST levels. However, these elevated liver enzymes returned to normal after 1 month of treatment. After that, liver enzymes remained normal throughout the treatment course in all patients. One patient in relapse showed elevation of serum ALT & AST levels 3 months after discontinuation of treatment. Most patients experienced interferon-related systemic side effects, which included malaise (100%), nausea (92%), myalgia (93%), headache (69%), low-grade fever (62%), & hair loss (62%). Hct decreased from 34±3.6 to 29.2±4.6% after treatment, WBCs from 5723±1622 to 4338±1518, & platelet form 160923±43929 to 149250±66517. Our data support the findings that interferon α-2a is effective in treating HD patients with HCV infection. However, the frequency of relapse after discontinuation of treatment suggests that reinforced therapeutic schedules should be patients.