Hepatitis C-related liver disease in dialysis patients

Fabrizio Fabrizi, Vivek Dixit, Piergiorgio Messa, Paul Martin

Research output: Chapter in Book/Report/Conference proceedingChapter

11 Scopus citations

Abstract

Hepatitis C virus (HCV) remains the most common cause of liver damage in patients with chronic kidney disease including patients on long-term dialysis. The natural history of HCV infection in patients with chronic kidney disease is not fully elucidated despite the adverse effect of HCV infection on survival in patients receiving long-term dialysis. A recent meta-analysis of seven observational studies (11,589 patients on dialysis) reported that the summary estimate for adjusted relative risk (all-cause mortality) with anti-HCV antibody was 1.34 with a 95% confidence interval of 1.13-1.59. As a cause of death, hepatocellular carcinoma and liver cirrhosis were significantly more frequent among anti-HCV-positive than -seronegative dialysis patients; the summary estimate for unadjusted liver-related mortality risk was 5.89 (95% confidence interval 1.93-17.99). Impairment of quality of life due to HCV has also been suggested to explain the diminished survival in this setting. Recent data also suggest an excess risk of cardiovascular disease in HCV-infected dialysis patients. Recent evidence supports the notion that the progression of HCV-related liver disease is probably slower in the dialysis population than in non-uremic patients despite the immune compromise conferred from chronic uremia; numerous mechanisms have been mentioned to explain it. It appears that the hemodialysis procedure per se reduces the HCV viral load, and the mechanisms by which this phenomenon occurs remain largely speculative - the intradialytic production of interferon-α, hepatocyte growth factor, or other cytokines provided with antiviral activities have been implicated. This is an area of intense investigation, and further studies are indicated.

Original languageEnglish (US)
Title of host publicationHepatitis C in Renal Disease, Hemodialysis and Transplantation
EditorsJose Morales, David Roth, Lionel Rostaing, Michel Jadoul, Josep Campistol, Beatriz Dominguez-Gil
Pages42-53
Number of pages12
DOIs
StatePublished - 2012

Publication series

NameContributions to Nephrology
Volume176
ISSN (Print)0302-5144

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Hepatitis C-related liver disease in dialysis patients'. Together they form a unique fingerprint.

  • Cite this

    Fabrizi, F., Dixit, V., Messa, P., & Martin, P. (2012). Hepatitis C-related liver disease in dialysis patients. In J. Morales, D. Roth, L. Rostaing, M. Jadoul, J. Campistol, & B. Dominguez-Gil (Eds.), Hepatitis C in Renal Disease, Hemodialysis and Transplantation (pp. 42-53). (Contributions to Nephrology; Vol. 176). https://doi.org/10.1159/000332379