Peginterferon Alfa-2a Plus Ribavirin Combination Treatment in Chronic Hepatitis C Post-Renal Transplant Patients

Inclusion Criteria: * Patients, male and female, aged 18 - 68 years * Post renal transplant patients exceeding one year * Anti-HCV (Abbott HCV EIA 2.0, Abbott Diagnostic, Chicago, IL) positive \> 6 months AND/OR * Detectable serum quantitative HCV-RNA (Cobas Amplicor HCV Monitor v2.0, Roche Molecular Systems, Pleasanton, CA) with lower limit of detection at 50 IU/mL * Compensated liver disease with the following minimum hematologic and biochemical criteria: * Hemoglobin \> 10 g/dL * WBC \> 3000/mm3 ; granulocyte count \> 1,500/mm3 * Platelet count \> 75,000/mm3 * Albumin within normal limits * TFT within normal limits * ANA \< 1:320 * Ultrasound of the liver obtained within the preceding 6 months of study entry * Liver biopsy prior to entry confirming a histological diagnosis consistent with HCV necroinflammatory score (METAVIR) \> 1, and fibrosis score \>/= 2. Exclusion Criteria: * Previous treatment with interferon and / or Ribavirin - based therapy for chronic hepatitis C * Co-infection with HBV or HIV * Chronic alcohol abuse (daily consumption \> 20 g/day) * Autoimmune or metabolic liver disease liver disease * Active drug-induced hepatitis or HAV * Decompensated liver disease (Child-Pugh classification B or C) including a past history of decompensation * Variceal bleeding * Evidence of severe retinopathy (e.g. CMV retinitis, macula degeneration) or clinically relevant ophthalmological disorder due to diabetes mellitis or hypertension * Neoplastic disease * Patients with a value of alpha-fetoprotein \>100 ng/mL will be excluded from the study until imaging studies confirm the absence of HCC. Presence of HCC, as determined by other means will also exclude the patient from histological sampling. * Patients with documented or presumed coronary artery disease or cerebrovascular disease should not be enrolled if, in the judgment of the investigator, an acute decrease in hemoglobin by up to 4 g/dL (40 g/L) (as may be seen with ribavirin therapy) would not be well-tolerated * History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease * Evidence of drug abuse (including excessive alcohol consumption) within one year of study entry * Current pregnancy, ongoing breast feeding or unwilling to have contraception * Bleeding or clotting diatheses * Recent history of renal allograft rejection (\< 6 months) * Inability or unwillingness to provide informed consent or abide by the requirements of the study. * History or other evidence of severe illness or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study. * History of organ transplantation, other than kidney, with an existing functional graft. * Patients requiring dialysis or in whom dialysis is impending.