Safety and efficacy of low dose peginterferon-aipha-2a combined with Ribavirin treating chronic hepatitis C in renal transplant recipients

Objective To study the safety and efficacy of low dose Peginterferon-alpha 2α （PEG-INF-α-2α） combined with Ribavirin treating chronic hepatitis C in renal transplant recipients. Methods A total of 13 cases of HCV hepatitis were randomly divided into treatment and control groups. Seven cases in treatment group were given PEC-INF-α-2α （90 μg/week） and ribavirin （600 μg/day） for 16 to 48 weeks, and the rest 6 eases in control group were subjected to general liver protection and anti inflammatory treatment. All patients were followed up for more than 2 years. Results There were 5 cases getting early response in treatment group for 16 weeks, including four cases of complete response and no non-effects response patients. In 4 cases voluntarily receiving treatment for 48 weeks, I case had facial muscle myalgia and increased Cr level at 35th week, humoral graft rejection was confirmed pathologically, and the treatment was terminated; 1 case had recurrence of HCV-RNA replication and PEG-INF-a-2a was withdrawn at 38th week. As results, 5 patients in the treatment group obtained complete response after two years, including 2 cases whose HCV-IgG had got negative, HCV RNA replication was significantly lower than in the control group, and the average Cr higher than in control group （P 〉 0. 05）. There were adverse reactions during this treatment protocol： fever, muscle myalgia, agranulocytosis, anemia and humoral graft rejection. Conclusion The efficacy of low dose PEG-INF-α-2a combined with ribavirin is definite in the treatment of chronic HCV hepatitis in kidney transplant recipients. The 16-week treatment duration is reasonable. It is remarkable that PEG-INF-α-2α may cause humoral graft rejection and Cr crawling. Key words: Kidney transplantatiom Polyethylene glycols;  Interferon alfa-2α;  Ribavirin; Hepatitis C virus; Treatment outcome