Anti-viral therapy in haemodialysed HCV patients: efficacy, tolerance and treatment strategy.

Détails

ID Serval
serval:BIB_90D147FBC172
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Anti-viral therapy in haemodialysed HCV patients: efficacy, tolerance and treatment strategy.
Périodique
Alimentary Pharmacology and Therapeutics
Auteur(s)
Deltenre P., Moreno C., Tran A., Ollivier I., Provôt F., Stanke F., Lazrek M., Castel H., Canva V., Louvet A., Colin M., Glowacki F., Dharancy S., Henrion J., Hazzan M., Noel C., Mathurin P.
ISSN
1365-2036 (Electronic)
ISSN-L
0269-2813
Statut éditorial
Publié
Date de publication
2011
Volume
34
Numéro
4
Pages
454-461
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
BACKGROUND: In end-stage renal disease (ESRD) patients, hepatitis C virus (HCV) eradication improves patient and graft survival.
AIM: To determine optimal use of erythropoietin (EPO) and ribavirin, to compare ribavirin concentrations with those of HCV patients having normal renal function and to evaluate sustained virological response (SVR) in a prospective observatory of ESRD candidates for renal transplantation.
METHODS: Thirty-two naïve patients were treated with Peg-IFN-α2a and ribavirin. Two different schedules of ribavirin and EPO administration were used: starting ribavirin at 600mg per week and adapting EPO when haemoglobin (Hb) fell below 10g/dL (adaptive strategy) or starting ribavirin at 1000mg per week while increasing EPO from the start of treatment (preventive strategy).
RESULTS: Patients treated with the adaptive strategy had lower median Hb levels (9.6 vs. 10.9g/dL, P=0.02) and more frequent median Hb levels below 10g/dL (58 vs. 5%, P=0.0007) despite lower median ribavirin doses (105 vs. 142mg/day, P<0.0001) than patients treated with the preventive strategy. There was a trend for more frequent transfusion in patients treated with the adaptive strategy than in patients treated with preventive strategy (50 vs. 20%, P=0.08). Compared to patients with normal renal function, ESRD patients had lower ribavirin concentrations during the first month (0.81 vs. 1.7mg/L, P=0.007) and similar concentrations thereafter. SVR was reached in 50%.
CONCLUSIONS: Pegylated interferon (Peg-IFN) and an adapted schedule of ribavirin are effective in ESRD patients. Increasing EPO from the start of treatment provides better haematological tolerance. The optimal dosage of ribavirin remains unresolved, in light of frequent side effects.
Mots-clé
Adult, Antiviral Agents/administration & dosage, Antiviral Agents/adverse effects, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Follow-Up Studies, Hepatitis C, Chronic/drug therapy, Humans, Interferon-alpha/administration & dosage, Interferon-alpha/adverse effects, Kidney Failure, Chronic/therapy, Kidney Transplantation, Male, Middle Aged, Polyethylene Glycols/administration & dosage, Polyethylene Glycols/adverse effects, Recombinant Proteins, Renal Dialysis, Ribavirin/administration & dosage, Ribavirin/adverse effects, Time Factors, Treatment Outcome, Viral Load
Pubmed
Web of science
Création de la notice
06/12/2013 11:09
Dernière modification de la notice
20/08/2019 15:54
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