Chronic HCV in Patients with Renal Disease

摘要: Hepatitis C virus infection remains prevalent in dialysis patients and renal transplant recipients. Treatment of HCV with chronic kidney disease (CKD) is predicated on the premise that associated decreased patient survival. All CKD should be evaluated for antiviral treatment decision to treat based potential benefits risks therapy (including life expectancy, candidacy transplantation, comorbidities). There good information supporting HCV-infected candidates; these goals include avoid HCV-related extra-hepatic complications after RT (i.e., de novo glomerulonephritis, new onset diabetes transplant, infections, allograft nephropathy). The summary estimate sustained virological response (SVR) drop-out rate monotherapy standard or pegylated interferon patients, according recent meta-analyses, around 33–37 17–23% respectively. Recent data support use ribavirin setting, implementation some safety precautions. viral receiving IFN plus was 56% (95% CI, 28–84). No are available yet confirm achieving SVR translates into improved survival population infection. However, successful can improve other outcomes (e.g., liver histology). Pretransplant biopsy crucial determine severity hepatic injury thereby assess prognosis patient. Antiviral virtually contraindicated transplantation as frequency acute rejection induced by great (up 50%). Kidney considered choice stage 5 HCV. A risk related kidneys from HCV-positive donors cannot excluded.