Copyright
©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 7, 2012; 18(1): 55-63
Published online Jan 7, 2012. doi: 10.3748/wjg.v18.i1.55
Efficacy and safety of treatment of hepatitis C virus infection in renal transplant recipients
Abdulrahman A Aljumah, Mohamed A Saeed, Ahmed I Al Flaiw, Ibrahim H Al Traif, Abduljaleel M Al Alwan, Salem H Al Qurashi, Ghormallah A Al Ghamdi, Fayez F Al Hejaili, Mohammed A Al Balwi, Abdulla A Al Sayyari
Abdulrahman A Aljumah, Mohamed A Saeed, Ibrahim H Al Traif, Abduljaleel M Al Alwan, Division of Hepatology, Department of Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11324, Saudi Arabia
Ahmed I Al Flaiw, Salem H Al Qurashi, Ghormallah A Al Ghamdi, Fayez F Al Hejaili, Abdulla A Al Sayyari Division of Nephrology and Renal Transplantation, Department of Medicine, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11324, Saudi Arabia
Mohammed A Al Balwi, Division of Molecular Pathology and Genetics, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11324, Saudi Arabia
Author contributions: Aljumah AA designed the study, drafted the manuscript, analyzed data, wrote the paper and gave final approval of the version for publication; Saeed MA, Al Flaiw AI, Al Traif IH, Al Alwan AM, Al Qurashi SH, Al Ghamdi GA and Al Hejaili FF collected data, critically revised the manuscript and gave final approval of the version for publication; Al Balwi MA analyzed and revised virological data and gave final approval of the version for publication; Al Sayyari AA analyzed data, performed statistical analysis, revised the manuscript and gave final approval of the version for publication.
Supported by King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
Correspondence to: Abdulrahman A Aljumah, MD, FRCPI Consultant Hepatologist and Liver Transplant Physician Head, Division of Hepatology, Department of Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, PO Box 225264, Riyadh 11324, Saudi Arabia. draljumah@hotmail.com
Telephone: +966-1-2520088-16786 Fax: +966-1-2520438
Received: February 22, 2011
Revised: April 20, 2011
Accepted: April 27, 2011
Published online: January 7, 2012
AIM: To assess the efficacy and safety of combined pegylated interferon and ribavirin therapy in hepatitis C virus (HCV) infection in renal transplant recipients.
METHODS: This is a retrospective chart review of post renal transplant patients who were positive for anti-HCV and HCV-RNA, and who have received treatment with combination of pegylated interferon and ribavirin between October 2003 and December 2008. Only patients with stable graft function and absence of evidence of cirrhosis and who received the therapy for continuous 48 wk were included. Nineteen patients (13 male and 6 female) were identified and included. The patient’s complete blood count, liver and kidney profile, and calculated glomerular filtration rate (GFR) were monitored every 6-8 wk while on treatment. HCV-RNA was tested at 12 wk for early virological response, at 48 wk for end of treatment response (ETR), and then retested at 24, and 48 wk after completion of therapy for sustained virological response (SVR). Liver biopsies were obtained before treatment from all patients and graft kidney biopsies were performed as required.
RESULTS: Of the entire cohort, 9 patients (47.4%) showed an ETR and 8 had SVR (42.1%). Of the 8 patients with abnormal alanine aminotransferase (ALT) levels at baseline, 78.9% had their ALT normalized (including the virological non responders). ALT was normal in all responders at the end of therapy and at 24 wk post therapy (100%). Only one patient (5.3%) developed an increase in creatinine and decline in GFR from baseline towards the end of treatment. This patient’s kidney biopsy revealed borderline rejection. There was no impact on response by HCV-genotype, initial HCV RNA load, age or sex of the patient or duration post transplant before commencement of therapy. All patients tolerated treatment in the same way as non-transplant with no unusual or increased occurrence of side effects.
CONCLUSION: The combination of pegylated interferon and ribavirin is effective in suppressing HCV-RNA, with a low risk of graft rejection or failure in HCV infected renal transplant recipients.
