Mogahed Engy A, Abdelaziz Hanan, Helmy Heba, Ghita Haytham, Abdel Mawla Mohamed A, Hassanin Fetouh, Fadel Fatina I, El-Karaksy Hanaa
1 Department of Pediatrics, Kasr Alainy Medical School, Cairo University , Cairo, Egypt .
2 Department of Pediatrics, National Research Centre , Cairo, Egypt .
J Interferon Cytokine Res. 2016 Dec;36(12):681-688. doi: 10.1089/jir.2016.0019. Epub 2016 Sep 22.
Treatment of hepatitis C virus (HCV) in end-stage renal disease (ESRD) patients is an important issue before kidney transplantation (KT). The aim of the study is to assess the efficacy and tolerability of HCV treatment with pegylated interferon (PEG IFN)-α 2b in children with ESRD. The study included 17 children, aged 3-18 years with ESRD on hemodialysis (HD), with chronic HCV. They received 40 μg/m of PEG IFN-α 2b once-weekly subcutaneous injections for 48 weeks. Early virological response (EVR) was achieved in 76.5%. At week 24, 8 patients had negative HCV RNA. Six patients received KT during therapy. Treatment was discontinued in 2 patients: one for anemia and another for retinopathy. Two patients completed 48 weeks of therapy and both achieved end-of-treatment response and sustained virological response (SVR). Constitutional symptoms were the most frequently reported side effects. Neutropenia occurred in 10 patients (58.8%), drop in hemoglobin in 10, and thrombocytopenia in 9. HCV-infected children with ESRD on HD have high EVR (76.5%) on IFN monotherapy. SVR could not be assessed due to the high dropout rate related mainly to early transplantation. Constitutional symptoms and hematological side effects were the most frequently reported side effects.
在终末期肾病（ESRD）患者中，丙型肝炎病毒（HCV）的治疗是肾移植（KT）前的一个重要问题。本研究的目的是评估聚乙二醇化干扰素（PEG IFN）-α 2b治疗ESRD儿童HCV的疗效和耐受性。该研究纳入了17名年龄在3至18岁、接受血液透析（HD）且患有慢性HCV的ESRD儿童。他们接受每周一次皮下注射40μg/m的PEG IFN-α 2b，共48周。76.5%的患者实现了早期病毒学应答（EVR）。在第24周时，8例患者的HCV RNA呈阴性。6例患者在治疗期间接受了KT。2例患者停止治疗：1例因贫血，另1例因视网膜病变。2例患者完成了48周的治疗，均实现了治疗结束时的应答和持续病毒学应答（SVR）。全身症状是最常报告的副作用。10例患者（58.8%）出现中性粒细胞减少，10例出现血红蛋白下降，9例出现血小板减少。接受HD的ESRD HCV感染儿童接受干扰素单药治疗时具有较高的EVR（76.5%）。由于主要与早期移植相关的高脱落率，无法评估SVR。全身症状和血液学副作用是最常报告的副作用。
