Interferon Therapy in Patient With ESRD and Cirrhosis?
Interferon Therapy in Patient With ESRD and Cirrhosis?
Is there a contraindication to interferon (IFN) therapy in dialysis patients with hepatitis C virus (HCV) infection and compensated cirrhosis before kidney transplantation?
Javier Omodeo, MD
There is no absolute contraindication to IFN therapy in patients with end-stage renal disease (ESRD) and well-compensated cirrhosis; however, it has been widely documented that patients (with or without renal failure) with cirrhosis generally do not respond to IFN therapy, even when IFN is used in combination with ribavirin. Therefore, one has to determine how active the hepatitis is and whether the patient has favorable HCV genotype (non-1). If the patient is well compensated, has a favorable genotype, and has active disease on liver histology, one can try IFN -- possibly pegylated interferon (long-acting) -- with very close monitoring for side effects and response to therapy.
Is there a contraindication to interferon (IFN) therapy in dialysis patients with hepatitis C virus (HCV) infection and compensated cirrhosis before kidney transplantation?
Javier Omodeo, MD
There is no absolute contraindication to IFN therapy in patients with end-stage renal disease (ESRD) and well-compensated cirrhosis; however, it has been widely documented that patients (with or without renal failure) with cirrhosis generally do not respond to IFN therapy, even when IFN is used in combination with ribavirin. Therefore, one has to determine how active the hepatitis is and whether the patient has favorable HCV genotype (non-1). If the patient is well compensated, has a favorable genotype, and has active disease on liver histology, one can try IFN -- possibly pegylated interferon (long-acting) -- with very close monitoring for side effects and response to therapy.
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