Hepatitis C virus and kidney disease

Paul Martin, Fabrizio Fabrizi

Research output: Contribution to journalReview articlepeer-review

85 Scopus citations

Abstract

Hepatitis C virus (HCV) infection remains frequent in patients on renal replacement therapy and has an adverse impact on survival in infected patients on chronic hemodialysis as well as renal transplant (RT) recipients. Nosocomial spread of HCV within dialysis units continues to occur. HCV is also implicated in the pathogenesis of renal dysfunction often mediated by cryoglobulins leading to chronic kidney disease as well as impairing renal allograft function. The role of antiviral therapy for hepatitis C in patients with renal failure remains unclear. Monotherapy with conventional interferon (IFN) for chronic hepatitis C is probably more effective in dialysis than in non-uraemic patients but tolerance is lower. Limited data only are available about monotherapy with pegylated interferon and combination therapy (pegylated IFN plus ribavirin) for chronic HCV in the dialysis population. Clinical experience with antiviral therapy for acute HCV in dialysis population is encouraging. Interferon remains contraindicated post-RT because of concerns about precipitating graft dysfunction. Sustained viral responses obtained by antiviral therapy in renal transplant candidates are durable after renal transplantation and may reduce HCV-related complications after RT (post-transplant diabetes mellitus, HCV-related glomerulonephritis, and chronic allograft nephropathy).

Original languageEnglish (US)
Pages (from-to)613-624
Number of pages12
JournalJournal of Hepatology
Volume49
Issue number4
DOIs
StatePublished - Oct 2008

Keywords

  • Dialysis
  • Glomerulonephritis
  • Hepatitis C virus
  • Interferon
  • Renal failure
  • Renal transplantation
  • Ribavirin

ASJC Scopus subject areas

  • Gastroenterology

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