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NDT Plus Advance Access originally published online on June 5, 2008
NDT Plus 2008 1(4):233-235; doi:10.1093/ndtplus/sfn069
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pegylated interferon alpha-2a monotherapy in a peritoneal dialysis patient with chronic hepatitis C

Imari Mimura1, Yoshitaka Ishibashi1, Ryosuke Tateishi2, Shinya Kaname3 and Toshiro Fujita1

1 Department of Nephrology and Endocrinology
2 Department of Gastroenterology, University of Tokyo School of Medicine
3 First Department of Internal Medicine, Kyorin University, Tokyo, Japan

Correspondence: Shinya Kaname, First Department of Internal Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan. Tel: +81-42247-5511; E-mail: kaname-tky{at}umin.ac.jp


  Abstract

Background: Although pegylated interferon (PEG-IFN) is now the standard treatment for chronic hepatitis C, there are few reports targeting dialysis patients and treatment protocol for hepatitis C virus (HCV) infection has not been determined, particularly in patients on peritoneal dialysis.

Case: A 34-year-old woman with chronic hepatitis C started peritoneal dialysis because of progressive renal disease 2 years after peripheral blood stem cell transplantation for aplastic anaemia. The regimen was a single 6-h dwell of 2L glucose dialysate. Considering that her HCV genotype was 2a and that she was a candidate for cadaveric kidney transplant, we decided to treat her with PEG-IFN alpha-2a monotherapy 1 year after the beginning of peritoneal dialysis. We adopted a dose escalation strategy to minimize the total amount of PEG-IFN administration, thereby reducing the risk of adverse effects. Her HCV-RNA disappeared at the 17th week and sustained virus response was achieved thereafter. Only minor side effects were observed including flu-like symptoms and mild anaemia, and residual renal function remained stable during the treatment of 48 weeks (renal Kt/V; from 1.28 to 1.26).

Conclusion: PEG-IFN monotherapy with dose modification may be a safe and effective treatment for HCV infection in patients undergoing peritoneal dialysis.

Key Words: HCV • interferon • peritoneal dialysis • transplantation

Received for publication April 21, 2008. Accepted for publication May 19, 2008.


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