Evolving therapies for hepatitis C virus in chronic kidney disease: the beginning of a new era

Abstract

Purpose of review: The current review highlights recent advances in treatment of chronic hepatitis C virus infection using new classes of agents, direct-acting antivirals (DAAs), with a focus on the evidence for their use in the setting of chronic kidney disease (CKD) stages 4-5, hemodialysis, and kidney transplantation.

Recent findings: DAA agents target-specific proteins involved in the hepatitis C virus life cycle and interrupt viral replication. Sustained virologic response, a marker of viral eradication, occurs in more than 90% of patients treated with DAA agents in the general population. Emerging data demonstrate similar sustained virologic response rates for specific DAA-based regimens in patients with CKD stages 4-5, hemodialysis patients, and kidney-transplant recipients.

Summary: High sustained virologic response rates are seen with DAA agents in CKD populations. A thoughtful approach to the timing of treatment is required to facilitate timely access to kidney transplantation.