[Hepatitis C virus and chronic progressive kidney disease]

Area of Science:

• Nephrology
• Hepatology
• Infectious Diseases

Context:

• Hepatitis C virus (HCV) is closely linked to chronic kidney disease (CKD), acting as both a cause and consequence.
• HCV contributes to various forms of glomerulonephritis (GN) and is frequently found in patients with end-stage renal disease (ESRD) and those undergoing dialysis or transplantation.
• Transmission routes in CKD patients include blood transfusions, nosocomial spread in dialysis units, and kidney grafts, leading to higher HCV prevalence compared to the general population.

Purpose:

• To review the intricate relationship between HCV and CKD.
• To discuss the challenges and therapeutic strategies for managing HCV infection in CKD patients, particularly those awaiting or receiving kidney transplants.

Summary:

• HCV is a significant cause of glomerulonephritis and is prevalent in dialysis and transplant patients due to specific transmission routes.
• Treatment of HCV in CKD patients presents challenges, including drug tolerance and dosage adjustments due to decreased glomerular filtration rate (GFR).
• Interferon-alpha (IFN-alpha) therapy demonstrates efficacy in hemodialysis patients, showing good virologic and biochemical responses and potentially benefiting post-transplant liver disease, making it advisable for transplant candidates.

Impact:

• Highlights the importance of managing HCV in CKD patients to improve outcomes.
• Provides insights into the efficacy of IFN-alpha therapy for HCV-infected dialysis patients, particularly those undergoing renal transplantation.
• Emphasizes the need for strict precautions in dialysis units to prevent HCV transmission.