Hepatitis C treatment in patients with kidney disease.

摘要: Hepatitis C virus (HCV) remains the most common cause of liver damage in patients with kidney disease, including those on long-term dialysis. The natural history HCV regular dialysis is not fully elucidated, but an adverse effect survival has been noted; a novel meta-analysis observational studies (14 145,608 unique patients) showed that summary estimate for adjusted relative risk (all-cause mortality) was 1.35 95% confidence interval 1.25–1.47. RR disease–related death and cardiovascular mortality among maintenance 3.82 (95% CI, 1.92–7.61) 1.26 1.10–1.45), respectively. It recommended decision to treat chronic disease be based potential benefits risks therapy, life expectancy, candidacy transplant, comorbidities. A pooled analysis 494 monotherapy conventional interferon reported sustained viral response dropout rate 39% 32–46) 19% 13–26), All renal transplant candidates (dialysis dependent or not) should assessed antiviral treatment given increased progressive immunosuppressive expectancy compared other HCV-positive dialysis, inability receive after transplant. Current guidelines support standard these patients, modern approaches (that is, dual therapy peg-IFN plus ribavirin) well-controlled setting may appropriate alternative.