Treatment of HCV in Renal Disease: Subtle Management Considerations in the Era of Direct-acting Antivirals
- PMID: 28584732
- PMCID: PMC5455785
- DOI: 10.1007/s11901-016-0319-5
Treatment of HCV in Renal Disease: Subtle Management Considerations in the Era of Direct-acting Antivirals
Abstract
Chronic hepatitis C virus (HCV) infection is burdensome in patients with chronic kidney disease and contributes to substantial liver-related and all-cause morbidity and mortality. HCV infection itself may cause kidney dysfunction, as exemplified through mixed cryoglobulinemic vasculitis. HCV is more prevalent in patients with significant kidney disease compared to the general population, and recent reports have shown inadvertent HCV transmission in U.S. hemodialysis centers. Further, HCV has been demonstrated to accelerate kidney dysfunction and is associated with worse clinical outcomes in patients with kidney disease. As such, the HCV-infected population with concurrent kidney disease is an important patient subgroup that warrants focused medical care and attention. With the advent of direct-acting antivirals (DAAs), the successful treatment of HCV is now a medical reality for many patients. Nuances in regimen selection and timing need to be considered when treating those with kidney dysfunction, particularly for those considering kidney transplantation.
Keywords: Chronic kidney disease; Direct-acting antivirals; Hepatitis C virus.
Conflict of interest statement
Compliance with Ethics Guidelines Conflict of Interest Dr. Andrew Muir reports grants and personal fees from Abbvie, grants and personal fees from BMS, grants and personal fees from Gilead, grants and personal fees from Merck, during the conduct of the study. Dr. Yuval Patel
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