Peg interferon causes nephropathy

[4est]

Source
Division of Nephrology, Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Department of Pathology, Veterans General Hospital-Taipei, and Department of Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Abstract
Interferon is used to treat chronic viral hepatitis because of low drug resistance and a high remission rate. However, its propensity to induce and modify autoimmunity has been reported. We used pegylated interferon ?-2a to treat a patient with chronic viral hepatitis B. After 5 months of this therapy, the patient developed membranous nephropathy. Complete remission of his nephrotic syndrome was achieved after 1 year of cyclosporine and corticosteroid therapy. During this same period, his chronic viral hepatitis B was controlled by entecavir. To our knowledge, this is the first case in which membranous nephropathy developed during pegylated interferon ?-2a therapy for chronic hepatitis B. The autoimmune modulation induced by interferon is the most likely mechanism for this complication.



Clin Nephrol.
2012 Jun;77(6):496-500.
Membranous nephropathy induced by pegylated interferon alpha-2a therapy for chronic viral hepatitis B.
Tsai MS:
http://www.ncbi.nlm.nih.gov/pubmed?term=Tsai%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=22595393 , Chen JH:
http://www.ncbi.nlm.nih.gov/pubmed?term=Chen%20JH%5BAuthor%5D&cauthor=true&cauthor_uid=22595393 , Fang YW:
http://www.ncbi.nlm.nih.gov/pubmed?term=Fang%20YW%5BAuthor%5D&cauthor=true&cauthor_uid=22595393 , Yang AH:
http://www.ncbi.nlm.nih.gov/pubmed?term=Yang%20AH%5BAuthor%5D&cauthor=true&cauthor_uid=22595393 , Chang CH:
http://www.ncbi.nlm.nih.gov/pubmed?term=Chang%20CH%5BAuthor%5D&cauthor=true&cauthor_uid=22595393

Source
Division of Nephrology, Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Department of Pathology, Veterans General Hospital-Taipei, and Department of Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Abstract
Interferon is used to treat chronic viral hepatitis because of low drug resistance and a high remission rate. However, its propensity to induce and modify autoimmunity has been reported. We used pegylated interferon ?-2a to treat a patient with chronic viral hepatitis B. After 5 months of this therapy, the patient developed membranous nephropathy. Complete remission of his nephrotic syndrome was achieved after 1 year of cyclosporine and corticosteroid therapy. During this same period, his chronic viral hepatitis B was controlled by entecavir. To our knowledge, this is the first case in which membranous nephropathy developed during pegylated interferon ?-2a therapy for chronic hepatitis B. The autoimmune modulation induced by interferon is the most likely mechanism for this complication.

[StephenCastlecrag]

"To prescribe interferon when ALT levels are not elevated is tantamount to giving bullets to an army that is not at war"  - I have to disagree. Interferon is more than just bullets, they are machine guns.So may be the question should be: are machine guns useless when the army is not at war?

[Dee1956]

Do you have nephropathy?
Dee

[stef2011]

just one case means nothing, single cases of neph happened with tdf and etv too and intf made also fulminant hepatitis in single cases.i mean these drugs can all be lethal in single cases and all needs careful monitoring by doctors, intf in particular

[imdb90]

Interferon can mess your entire body and immune system (new or worsening autoimmune problems). Interferon is like a machine gun (shouts a lot of bullets but few damage the enemy), because isn't very effective at spurring the immune system to target HBV. The best rate of succes with interferon alfa 2a is:
Elevated ALTs indicate the immune system has noticed the infection and is attacking and killing the infected liver cells. To prescribe interferon when ALT levels are not elevated is tantamount to giving bullets to an army that is not at war. Conventional and pegylated interferon, administered by injection, works best when ALT is elevated and viral load is low - when the army is on the attack and there are few viruses to vanquish. Pegylated interferon, which is a time-release interferon requiring only one injection per week, is much more effective at spurring the immune system to target HBV than conventional interferon.

Maybe interferon lambda will be more specific attacking hbv, reducing the risk of developing autoimmune disease.