The effect of IFN therapy was evaluated by measurement of the serum HCV RNA level at 6 months after completion of the therapy. Although all treatments were covered by the National Health Insurance of Japan, they were performed with the approval of the institutional review board of Jikei University School of Medicine. Figure 1 shows the fluctuations of serum HCV RNA levels of each patient. In both patients, sustained viral response was achieved by combined DFPP plus 24 weeks of i.v. IFN-β therapy. While twice-daily injections of IFN-β for 2 weeks could be completed, there were no adverse

Selleck PD0325901 events, including DFPP, that necessitated discontinuation or reduction in the dose of IFN-β. PERSISTENT HCV INFECTION has been suggested by a number of studies as an important prognostic factor in HD patients. Because serum levels of aspartate aminotransferase selleck compound and alanine aminotransferase are low in HD patients, it is difficult to determine the presence or absence of hepatic disease in these patients.[9] Consequently, the

natural history of HCV infection in HD patients has not yet been clearly elucidated. However, the frequency of deaths associated with hepatic disease in HD patients is too high to ignore in terms of the cause of death.[10] Moreover, liver biopsy performed in HD patients, although in a small number of patients, has revealed similar histological progression of hepatic disease to that in

non-HD patients.[11] These data suggested the importance of HCV eradication by antiviral therapy to improve the prognosis of HD patients with HCV infection and both US and Japanese guidelines recommended antiviral therapy in HD patients.[12, 13] In addition, the therapeutic effect of IFN monotherapy is reported to be superior in HD patients as compared with that in non-HD patients.[14] However, one of the big obstacles to effective treatment of HCV infection in HD patients is that ribavirin, which enhances the therapeutic effects of IFN, has a critical disadvantage on account of the inevitable occurrence many of hemolysis as an adverse effect in HD patients.[15] It has been reported that a reduced dose of ribavirin can be applied with IFN in HD patients, however, tuning of ribavirin dose is very difficult, and monitoring of serum concentration of ribavirin may be essential in continuing the therapy.[16] The effects of IFN monotherapy administrated according to the current protocol are extremely limited in patients with HCV genotype 1b infection with elevated blood HCV RNA levels. Herein, we have shown that a combination of virus eradication from the blood by DFPP plus twice-daily injections of IFN-β, which enhances the antiviral effects of IFN, reduced the blood HCV RNA levels to below the detectable level in the early stage of treatment, similar to that previously reported in the case of non-HD patients.