Name of journal: World Journal of Gastroenterology esps manuscript no: 12307 Columns: Topic Highlight



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P-Reviewer: Chuang WL, Lai S, Ohsawa M S-Editor: Ma YJ L-Editor: E-Editor:



Figure 1 Treatment decision algorithm for hepatitis C virus-infected chronic kidney disease patients under conservative management. 1Adjusted doses according to eGFR. eGFR: Estimated glomerular filtration rate.



Figure 2 Treatment decision algorithm for hepatitis C virus-infected chronic kidney disease patients under  hemodialysis who are candidates for kidney transplantation. 1By real-time PCR or TMA; 2APRI, FibroTest or transient hepatic elastography; 3Adjusted doses (see text for details). PEG-IFN: Pegylated interferon; KT: Kidney transplantation; SVR: Sustained virological response.

Figure 3 Treatment decision algorithm for hepatitis C virus-infected kidney transplantation recipients. 1Particularly if time after transplantation > 5 years; 2APRI, TX3, FibroTest or transient hepatic elastography; 3Adjusted doses according to eGFR. PEG-IFN: Pegylated interferon; RBV: Ribavirin; eGFR: Estimated glomerular filtration rate.



Ref.

Süleymanlar et al[26] (1998)

Gürsoy et al[27]

(2001)

Urbánek et al[28]

(2004)

Al-Harbi et al[29]

(2005)

Rocha et al[30]

(2007)

Engel et al[32]

(2007)

Liu et al[33]

(2010)

Ferreira et al[31]

(2011)

n

3

36

18

9

23

10

35

26

Interferon

type


IFN

IFN

IFN

IFN

IFN

PEG-IFN α2b

PEG-IFN α2a

IFN

PEG-IFN α2a



Schedule

4.5 MU tiw

3 MU or

6-10 MU tiw



10 MU +

3 MU tiw



3 MU tiw

3 MU or

6 MU tiw



1 μg/kg qw

135 μgv qw

3 MU tiw

or 135 μg qw



Duration

16 wk

12 wk

3 wk + 12 wk

12 wk

48 or 24 wk

24 wk

24 wk

48 wk

SVR

100%

39%

72%

67%

43%

40%

89%

54%

Table 1 Studies on acute hepatitis C treatment in hemodialysis patients

IFN: Interferon; PEG-IFN: Pegylated interferon; MU: Million units; tiw: Three times a week; SVR: Sustained virological response rate by intention-to-treat analysis.


Table 2 Treatment regimens for hepatitis C virus infection in chronic kidney patients

Stage of CKD

Estimated GFR

Target dosage of ribavirin

Dosage of Interferon

1

≥ 90

800 to 1200 mg qd1

PEG-IFN α2a 180 μg qw

PEG-IFN α2b 1.5 μg/kg qw



2

60 to 89

600 to 800 mg qd1

3

30 to 59

400 to 600 mg qd1

4

15 to 29

200 mg qd

PEG-IFN α2a 135 μg qw

PEG-IFN α2b 1.0 μg/kg qw



5

< 15 or HD

Titrated according to patient tolerability2

1Divided in two doses; 2See text for details. GFR: Glomerular filtration rate expressed in mL/min per 1.73 m2; qd: Once a day; PEG-IFN: Pegylated interferon; qw: Once a week; HD: Hemodyalisis.



Ref.

Year

Trials ( n)

Therapy

n

SVR1

Russo et al[95]

2003

11

IFN

213

33% (21%-51%)

Fabrizi et al[96]

2003

14

IFN

269

37% (28%-48%)

Gordon et al[97]

2008

20

5


IFN

PEG-IFN


459

87


41% (33%-49%)

37% (9%-77%)



Fabrizi et al[99]

2008

24

4


IFN

PEG-IFN


529

116


39% (32%-46%)

31% (7%-55%)



Gordon et al[98]

2009

20

IFN

428

45%

Alavian et al[100]

2010

21

12


IFN

PEG-IFN


491

279


39% (32%-46%)

39% (27%-52%)



Fabrizi et al[101]

2010

16

PEG-IFN

254

33% (24%-43%)

Fabrizi et al[102]

2011

10

PEG-IFN+RBV

151

56% (28%-84%)

Fabrizi et al[103]

2014

11

PEG-IFN+RBV

287

60% (28%-97%)

Table 3 Meta-analyses on the treatment of chronic hepatitis C in hemodialysis patients

1Mean overall estimate for sustained virological response (range). IFN: Interferon; PEG-IFN: Pegylated interferon; RBV: Ribavirin.

Table 4 Studies on the treatment of chronic hepatitis C in kidney transplant recipients

Ref

Year

n

Therapy

Interferon dose

Duration

SVR

Harihara et al[154]

1994

3

IFN

3-6 MU biw

NA

NA

Therret et al[155]

1994

13

IFN

3-5 MU tiw

About 4

NA

Magnone et al[156]

1995

11

IFN

1.5-5.0 MU tiw

6

NA

Rostaing et al[157]

1995

14

IFN

3 MU tiw

About 5

0%

Ozgür et al[158]

1995

5

IFN

4.5 MU tiw

6

NA

Yasumura et al[159]

1997

6

IFN

6 MU tiw

About 7

33%

Durlik et al[160]

1998

11

IFN

3 MU tiw

About 6

0%

Hanafusa et al[161]

1998

10

IFN

9 MU tiw

6

10%

Tokumoto et al[162]

1998

6

IFN

9 MU tiw

6

50%

Baid et al[163]

2003

12

IFN+RBV

3 MU tiw

Variable

33%

Tang et al[164]

2003

4

IFN+RBV

3 MU tiw

12

50%

Shu et al[165]

2004

11

IFN+RBV

1 MU tiw

12

27%

Izopet et al[166]

1997

15

IFN

3 MU tiw

About 5

0%

Sharma et al[167]

2006

6

IFN+RBV

3 MU tiw

About 12

33%

Pageaux et al[168]

2009

8

PEG-IFNα2a

180 μg qw

6-12

50%

Aljumah et al[169]

2012

19

PEG-IFN+RBV

90-180 μg qw

12

42%

Sanai et al[170]

2013

32

PEG-IFN+RBV

135-180 μg qw

12

38%

IFN: Interferon; MU: Million units; biw: Two times a week; NA: Not available; tiw: three times a week; PEG-IFN: Pegylated interferon; RBV: Ribavirin; SVR: Sustained virological response rate by intention-to-treat analysis.





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