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[Hepatitis C infections in dialyzed patients]

Regina Beata Podlasin1

  • 1Oddział IV Wojewódzkiego Szpitala Zakaźnego w Warszawie. podlasin@cdit-aids.med.pl

Przeglad Epidemiologiczny
|September 30, 2005
PubMed

Insights

Hepatitis C virus (HCV) infection is common in patients undergoing dialysis for end-stage renal disease (ESRD). Antiviral therapy before renal transplantation is recommended due to treatment contraindications post-transplant.

Area of Science:

  • Nephrology
  • Hepatology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection is more prevalent in patients with end-stage renal disease (ESRD) undergoing dialysis compared to the general population.
  • The natural history and clinical course of HCV infection in dialyzed patients remain unclear, with varying opinions on its severity.
  • Immunosuppressive therapy post-renal transplantation (RTx) negatively impacts HCV-infected patients, and current anti-HCV treatments pose a high risk of graft rejection.

Purpose of the Study:

  • To review the current understanding of hepatitis C virus infection in dialyzed patients.
  • To evaluate the challenges and recommendations for antiviral therapy in ESRD patients, particularly concerning renal transplantation.
  • To highlight the need for wider indications for HCV treatment before RTx.

Main Methods:

  • Literature review focusing on studies related to HCV infection in ESRD patients on dialysis.
  • Analysis of available data on anti-HCV treatments, including interferon-based therapies and ribavirin.
  • Examination of treatment efficacy and safety in the context of renal transplantation.

Main Results:

  • Standard interferon monotherapy is the most studied treatment for HCV in dialyzed patients.
  • One pegylated interferon has been approved for dialyzed patients, but efficacy and safety data are limited.
  • Ribavirin use is contraindicated in ESRD patients due to the significant risk of anemia.

Conclusions:

  • Antiviral therapy for HCV infection should be administered prior to renal transplantation.
  • Treatment indications for HCV should be broadened to encompass HCV infection, not solely hepatitis.
  • Further research is needed on the efficacy and safety of newer antiviral agents, including pegylated interferons, in dialyzed ESRD patients.

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