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Hepatitis C and renal disease: an update.
Catherine M Meyers1, Leonard B Seeff, Catherine O Stehman-Breen
1Division of Kidney, National Institute of Diabetes and Digestive and Kidney Diseases, The National Institutes of Health, Bethesda, MD 20892, USA.
Summary
Hepatitis C virus (HCV) infection complicates chronic kidney disease, leading to serious conditions like cryoglobulinemia and glomerulonephritis. Managing HCV in kidney patients is challenging due to treatment difficulties and nosocomial spread risks in dialysis units.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is a significant factor in both the development and progression of chronic renal disease.
- HCV infection can precipitate immune complex-mediated renal syndromes, including cryoglobulinemia and membranoproliferative glomerulonephritis (MPGN).
Framework:
- The precise pathogenetic mechanisms linking chronic HCV infection to renal syndromes remain incompletely defined.
- HCV-related cryoglobulinemia and MPGN present management challenges, with variable responses to antiviral therapies.
Implementation:
- Hepatitis C complicates care for patients with end-stage renal disease and those undergoing renal transplantation.
- Nosocomial transmission is a concern in dialysis units, necessitating stringent screening and infection control measures.
- HCV infection adversely affects survival rates for both dialysis patients and kidney transplant recipients.
Implications:
- Antiviral therapy for hepatitis C in renal patients is often problematic, with limited efficacy and significant side effects.
- There is a critical need for further research into the pathogenesis, natural history, prevention, and treatment of hepatitis C in individuals with renal disease.