Hepatitis C Management

Ask The Experts

Question:

How do you manage a patient with HCV who is on hemodialysis?

Ribavirin is contraindicated in patients with a creatinine clearance less than 60 mL/min. There is some experimental use of very low doses of ribavirin in patients with more advanced renal disease (but who do not require dialysis), such as starting with 200 mg/wk and increasing slowly as tolerated. For patients on hemodialysis, monotherapy with interferon is recommended. As renal function decreases, the clearance of PEG-IFN is also affected and decreased doses are used.

For more information, see the section on HCV in Patients with Renal Disease in the Hepatitis C Management monograph.