Pegylated Interferon and Ribavirin to Treat Chronic Hepatitis C With and Without Kidney Disease

* INCLUSION CRITERIA: All Patients: * Age 18 years or above, male or female. * Presence of HCV RNA (with or without anti-HCV) in serum. * Genotype 1 HCV as determined by probe specific hybridization (Inno-Lipa assay). * Evidence of chronic hepatitis on liver biopsy done within the previous 48 months with a necroinflammatory histology activity index of at least 3 (out of a maximum of 18). * Written informed consent. Additional inclusion criteria for Groups A, B and D: \- Serum alanine (ALT) or aspartate aminotransferase (AST) above the upper limit of the normal range (ALT 41 greater than IU/L: AST greater than 31 IU/L) on any serum testing during the previous six months. Additional inclusion criteria for Group C: * Chronic renal disease with creatinine clearance less than 50 cc/min or serum creatinine greater than 2.0 mg%. * If on chronic hemodialysis or peritoneal dialysis, stable clinical condition including stable hematocrit. * If on chronic dialysis, potential candidacy for renal transplantation. EXCLUSION CRITERIA: * Previous treatment with alpha interferon. * If cirrhosis is present, decompensated liver disease, as marked by bilirubin greater than 4 mg%, albumin less than 3.0 gm%, prothrombin time greater than 2 sec prolonged, or history of bleeding esophageal varices, ascites or hepatic encephalopathy. * Serum ALT or AST levels greater than 1000 U/L (greater than 25 times ULN). Such patients will not be enrolled but may be followed until three determinations are…