Triple therapy for hepatitis C virus infection in patients receiving hemodialysis

摘要

TO THE EDITOR: We read Liu and colleagues' article (1) with great interest. Cure of hepatitis C virus (HCV) infection is crucial in patients receiving hemodialysis who are awaiting a kidney transplant. Hepatitis C virus infection is associated with decreased survival before and after kidney transplantation (2). However, interferon treatment after transplantation is contraindicated because of a high risk for acute rejection. Liu and colleagues report results of a randomized trial comparing the efficacy and safety of pegylated interferon plus low-dose riba-virin with those of pegylated interferon monotherapy in 205 treatment-naive patients with HCV infection receiving hemodialysis. They concluded that the virologic response was greater with combination therapy than monotherapy. However, the rate of sustained virologic response with combination therapy was only 64%. Protease inhibitors have significantly improved the viral re-sponse in patients with HCV genotype 1, but no data are available for patients with end-stage renal disease (3). Recently, the pharma-cokinetic properties of the protease inhibitor boceprevir were found to be similar in patients with end-stage renal disease and healthy control participants (4). A recent study found early rapid viral response in 3 of 4 patients receiving hemodialysis after 12 weeks of triple therapy with pegylated interferon-alpha2a, ribavirin, and telaprevir.