Evidence-Based Treatment of Hepatitis C after Kidney Transplantation with Combined Interferon-α and Ribavirin_Chinese Journal of Evidence-Based Medicine

Authors：

AO Feijian ,  HE Qing , JIANG Jinyan , TANG Wei , ZHANG Bin , LI Zhiyu , TANG Yimin

Department of Hepatology, the Third People’s Hospital of Shenzhen, Shenzhen 518020, China;

Corresponding author：

HE Qing, Email: heqingjoe@163.com

Keywords：

Kidney transplantation; Hepatitis C; Interferon α; Ribavirin; Evidence-based treatment

DOI：

10.7507/1672-2531.20090222

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To formulate an evidence-based treatment plan for a patient with hepatitis C after kidney transplantation with combination of interferon-α and ribavirin.
Methods 　Based on an adequate assessment of the patient’ s condition and using the principle of PICO, we searched The Cochrane Library (Issue 1, 2009), PubMed (1995 to March 2009), and CHKD (1995 to 2008.12).
Results 　Eighteen studies were identified including 17 in English (5 case reports, 11 cohort studies, and 1 meta–analysis) and 1 in Chinese. According to the current evidence as well as the patient’ s clinical condition and preference, PEG-IFNα-2b 50 µg /week plus ribavirin 600 mg/day was given to the patient for 6 months.
Conclusion 　Evidence-based approaches help us to prepare the anti-viral therapy plan and will improve the assessment of the efficacy and safety in kidney transplantation.

Citation： AO Feijian,HE Qing,JIANG Jinyan,TANG Wei,ZHANG Bin,LI Zhiyu,TANG Yimin. Evidence-Based Treatment of Hepatitis C after Kidney Transplantation with Combined Interferon-α and Ribavirin. Chinese Journal of Evidence-Based Medicine, 2009, 09(11): 1238-1240. doi: 10.7507/1672-2531.20090222 Copy

1.	Pageaux GP, Hilleret MN, Garrigues V, et al. Pegylated interferonalpha- based treatment for chronic hepatitis C in renal transplant recipients: an open pilot study. Transpl Int, 2009, 22(5): 562-567.
2.	Nanmoku K, Imaizumi R, Toj imbara T, e t al . Ef fect s of immunosuppressants on the progression of hepatitis C in hepatitis C virus-positive renal transplantation and the usefulness of interferon therapy. Transplant Proc, 2008, 40(7): 2382-2385.
3.	Rashid A, Abboud O, Al-Kaabi S, et al. The Impact of Hepatitis C Infection and Antiviral Therapy on clinical Outcome in Renal Transplantation Recipients. Saudi J Kidney Dis Transpl, 1999, 10(1): 31-35.
4.	Montalbano M, Pasulo L, Sonzogni A, et al. Treatment with pegylated interferon and ribavirin for hepatitis C virus-associated severe cryoglobulinemia in a liver/kidney transplant recipient. J Clin Gastroenterol, 2007, 41(2): 216-220.
5.	Sharma RK, Bansal SB, Gupta A, et al. Chronic hepatitis C virus infection in renal transplant: treatment and outcome. Clin Transplant, 2006, 20(6): 677-683.
6.	Carbognin SJ, Solomon NM, Yeo FE, et al. Acute renal allograft rejection following pegylated IFN-alpha treatment for chronic HCV in a repeat allograft recipient on hemodialysis: a case report. Am J Transplant, 2006, 6(7): 1746-1751.
7.	Zeman M, Campbel l P, Bain VG. Hepat i t is C eradicat ion and improvement of cryoglobulinemia-associated rash and membranoproliferative glomerulonephritis with interferon and ribavirin after kidney transplantation. Can J Gastroenterol, 2006, 20(6): 427-431.
8.	Konishi I, Horiike N, Michitaka K, et al. Renal transplant recipient with chronic hepatitis C who obtained sustained viral response after interferon-beta therapy. Intern Med, 2004, 43(10): 931-934.
9.	Shu KH, Lan JL, Wu MJ, et al. Ultralow-dose alpha-interferon plus ribavirin for the treatment of active hepatitis C in renal transplant recipients. Transplantation, 2004, 77(12): 1894-1896.
10.	Tang S, Cheng IK, Leung VK, et al. Successful treatment of hepatitis C after kidney transplantation with combined interferon alpha-2b and ribavirin. J Hepatol, 2003, 39(5): 875-878.
11.	Luciani G, Bossola M, Muscaritoli M, et al. Sustained response with negative serum HCV-mRNA and disappearance of antibodies after interferon-alpha therapy in a kidney transplant recipient with chronic active viral hepatitis C. J Nephrol, 2003, 16(3): 417-420.
12.	Baid S, Tolkoff-Rubin N, Saidman S, et al. Acute humoral rejection in hepatitis C-infected renal transplant recipients receiving antiviral therapy. Am J Transplant, 2003, 3(1): 74-78.
13.	Schmitz V, Kiessling A, Bahra M, et al. Peginterferon alfa-2b plus ribavirin for the treatment of hepatitis C recurrence following combined liver and kidney transplantation. Ann Transplant, 2007, 12(3): 22-27.
14.	Kamar N, Boulestin A, Selves J, et al. Factors accelerating liver fibrosis progression in renal transplant patients receiving ribavirin monotherapy for chronic hepatitis C. J Med Virol, 2005, 76(1): 61-68.
15.	Fontaine H, Vallet-Pichard A, Equi-Andrade C, et al. Histopathologic efficacy of ribavirin monotherapy in kidney allograft recipients with chronic hepatitis C. Transplantation, 2004, 78(6): 853-857.
16.	Kamar N, Sandres-Saune K, Selves J, et al. Long-term ribavirin therapy in hepatitis C virus-positive renal transplant patients: effects on renal function and liver histology. Am J Kidney Dis, 2003, 42(1): 184-192.
17.	Fabrizi F, Lunghi G, Dixit V, et al. Meta-analysis: anti-viral therapy of hepatitis C virus-related liver disease in renal transplant patients. Alimentary Pharmacology and Therapeutics, 2006, 24(10): 1413-1422.
18.	唐晓鹏, 赵洪雯, 余荣杰, 等. 小剂量干扰素α联合利巴韦林治疗肾移植术后继发丙型病毒性肝炎患者的疗效观察. 第三军医大学学报, 2008, 30(2): 117-119.
19.	Pereira BJG, Natov SN, Bouthot BA, et al. Effect of hepatitis C infection and renal transplantation on survival in end-stage renal disease. Kidney Int, 1998, 53: 1374-1381.
20.	Mathurin P, Mouquet C, Poynard T, et al. Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology, 1999, 29: 257-263.

1. Pageaux GP, Hilleret MN, Garrigues V, et al. Pegylated interferonalpha- based treatment for chronic hepatitis C in renal transplant recipients: an open pilot study. Transpl Int, 2009, 22(5): 562-567.
2. Nanmoku K, Imaizumi R, Toj imbara T, e t al . Ef fect s of immunosuppressants on the progression of hepatitis C in hepatitis C virus-positive renal transplantation and the usefulness of interferon therapy. Transplant Proc, 2008, 40(7): 2382-2385.
3. Rashid A, Abboud O, Al-Kaabi S, et al. The Impact of Hepatitis C Infection and Antiviral Therapy on clinical Outcome in Renal Transplantation Recipients. Saudi J Kidney Dis Transpl, 1999, 10(1): 31-35.
4. Montalbano M, Pasulo L, Sonzogni A, et al. Treatment with pegylated interferon and ribavirin for hepatitis C virus-associated severe cryoglobulinemia in a liver/kidney transplant recipient. J Clin Gastroenterol, 2007, 41(2): 216-220.
5. Sharma RK, Bansal SB, Gupta A, et al. Chronic hepatitis C virus infection in renal transplant: treatment and outcome. Clin Transplant, 2006, 20(6): 677-683.
6. Carbognin SJ, Solomon NM, Yeo FE, et al. Acute renal allograft rejection following pegylated IFN-alpha treatment for chronic HCV in a repeat allograft recipient on hemodialysis: a case report. Am J Transplant, 2006, 6(7): 1746-1751.
7. Zeman M, Campbel l P, Bain VG. Hepat i t is C eradicat ion and improvement of cryoglobulinemia-associated rash and membranoproliferative glomerulonephritis with interferon and ribavirin after kidney transplantation. Can J Gastroenterol, 2006, 20(6): 427-431.
8. Konishi I, Horiike N, Michitaka K, et al. Renal transplant recipient with chronic hepatitis C who obtained sustained viral response after interferon-beta therapy. Intern Med, 2004, 43(10): 931-934.
9. Shu KH, Lan JL, Wu MJ, et al. Ultralow-dose alpha-interferon plus ribavirin for the treatment of active hepatitis C in renal transplant recipients. Transplantation, 2004, 77(12): 1894-1896.
10. Tang S, Cheng IK, Leung VK, et al. Successful treatment of hepatitis C after kidney transplantation with combined interferon alpha-2b and ribavirin. J Hepatol, 2003, 39(5): 875-878.
11. Luciani G, Bossola M, Muscaritoli M, et al. Sustained response with negative serum HCV-mRNA and disappearance of antibodies after interferon-alpha therapy in a kidney transplant recipient with chronic active viral hepatitis C. J Nephrol, 2003, 16(3): 417-420.
12. Baid S, Tolkoff-Rubin N, Saidman S, et al. Acute humoral rejection in hepatitis C-infected renal transplant recipients receiving antiviral therapy. Am J Transplant, 2003, 3(1): 74-78.
13. Schmitz V, Kiessling A, Bahra M, et al. Peginterferon alfa-2b plus ribavirin for the treatment of hepatitis C recurrence following combined liver and kidney transplantation. Ann Transplant, 2007, 12(3): 22-27.
14. Kamar N, Boulestin A, Selves J, et al. Factors accelerating liver fibrosis progression in renal transplant patients receiving ribavirin monotherapy for chronic hepatitis C. J Med Virol, 2005, 76(1): 61-68.
15. Fontaine H, Vallet-Pichard A, Equi-Andrade C, et al. Histopathologic efficacy of ribavirin monotherapy in kidney allograft recipients with chronic hepatitis C. Transplantation, 2004, 78(6): 853-857.
16. Kamar N, Sandres-Saune K, Selves J, et al. Long-term ribavirin therapy in hepatitis C virus-positive renal transplant patients: effects on renal function and liver histology. Am J Kidney Dis, 2003, 42(1): 184-192.
17. Fabrizi F, Lunghi G, Dixit V, et al. Meta-analysis: anti-viral therapy of hepatitis C virus-related liver disease in renal transplant patients. Alimentary Pharmacology and Therapeutics, 2006, 24(10): 1413-1422.
18. 唐晓鹏, 赵洪雯, 余荣杰, 等. 小剂量干扰素α联合利巴韦林治疗肾移植术后继发丙型病毒性肝炎患者的疗效观察. 第三军医大学学报, 2008, 30(2): 117-119.
19. Pereira BJG, Natov SN, Bouthot BA, et al. Effect of hepatitis C infection and renal transplantation on survival in end-stage renal disease. Kidney Int, 1998, 53: 1374-1381.
20. Mathurin P, Mouquet C, Poynard T, et al. Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology, 1999, 29: 257-263.

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