Abstract
A 49-year-old woman, who had been receiving HD therapy for 11 years, was diagnosed as having chronic hepatitis C based on a positive anti-hepatitis C (HCV) antibody test, a positive HCV-RNA test by polymerase chain reaction, and liver needle biopsy findings with mild chronic active hepatitis. Interferon β (IFN β, 3 million units per day) was administered intravenously daily for 2 weeks prior to HD treatment, and subsequently three times per week for the next 6 weeks. The major adverse effects were episodic high fevers, which disappeared within one day, and granulocytopenia, which was treated with the use of granulocyte colony stimulating factor (G-CSF).
The pharmacokinetics of IEN β were studied. The changes in serum IFN β levels after injection on the HD days were not significantly different from those on the non HD days, and no accumulations of IFN β were seen during the observation period. IFN β was not detected in the filtrates, suggesting that there was no removal by dialysis therapy. After administration, the serum IFN β levels decreased immediately, and were almost undetectable within 4 hours. The biological half life of IEN β was 10.3 minutes on HD days and 13.2 minutes on non-HD days. HCV-RNA became negative one month after the IFN β treatment, and has remained negative for 6 months.
Although IEN β showed no dialyzability, IFN β did not seem to accumulate in HD patients because of its relatively short biological half life. Our patient's course suggests that IEN β is an effective choice for the therapy of hepatitis C infection in HD patients.
