Sustained Virologic Response with Triple Therapy in a Hemodialysis Patient with Chronic HCV Infection

Abstract

Chronic hepatitis C virus (HCV) infection is more prevalent and has been proven to be an independent risk factor over mortality among hemodialysis patients than normal population. Since sustained virologic response (SVR) is so beneficial and may be maintained in 90-100% of post-transplant cases, treatment of chronic HCV infection is strongly suggested for all patients undergoing renal transplantation. A 45-year-old male patient had been offered to have renal transplantation due to chronic renal failure, and referred to our clinic because of chronic HCV infection (HCV-RNA positive). He had received hemodialysis three times a week since 2007. The patient was diagnosed with chronic HCV infection fifteen years ago and was given a 48-week lasting IFN therapy in 2000 and a subsequent therapy of PEG-IFN-α2a for 48 weeks in 2004. Although both therapies had yielded end of treatment responses, subsequent relapses occurred. The patient was given a combination treatment involving PEG-IFN-α2a (135 μg/wk) for 24 weeks and ribavirin (200 mg/day) for 24 weeks and telaprevir (3 x 750 mg) for the first 12 weeks, and a weekly control visit in our clinic. The therapy was generally well tolerated and SVR was achieved. Triple therapy might be used as a treatment option in hemodialysis patients with genotype 1 chronic HCV infections.

Keywords

• Hemodialysis
• chronic renal failure
• chronic hepatitis C
• triple therapy