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Treatment of chronic hepatitis C virus infection in dialysis patients: an update

Hugo Weclawiak1, Nassim Kamar, Abdellatif Ould-Mohamed

  • 1Department of Nephrology, Dialysis, and Organ Transplantation, Toulouse University Hospital, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032- 31059- Toulouse Cédex 9, France.

Hepatitis Research and Treatment
|December 15, 2010
PubMed

Insights

Hepatitis C virus (HCV) infection is common in hemodialysis patients. Antiviral treatment during dialysis effectively clears the virus, preventing worsening of liver disease after kidney transplantation.

Area of Science:

  • Hepatology
  • Nephrology
  • Virology

Background:

  • Hepatitis C virus (HCV) infection historically had high prevalence in hemodialysis (HD) patients, primarily through nosocomial transmission.
  • HCV infection in HD patients often presents with normal liver enzymes but can show histological lesions.
  • Liver lesions associated with HCV may worsen post-kidney transplantation, complicating treatment due to rejection risks.

Purpose of the Study:

  • To evaluate the efficacy and safety of antiviral treatment for Hepatitis C virus in hemodialysis patients.
  • To determine the impact of pre-transplant antiviral therapy on HCV recurrence and liver disease progression after kidney transplantation.

Main Methods:

  • Assessment of HCV-related liver lesions using noninvasive tests in hemodialysis patients.
  • Implementation of antiviral treatment during dialysis therapy.
  • Monitoring viral clearance and sustained virological response rates.
  • Evaluation of HCV status post-kidney transplantation.

Main Results:

  • Antiviral treatment during dialysis therapy leads to a high rate of viral clearance.
  • Patients achieving sustained virological response show no relapse after kidney transplantation, even with immunosuppression.
  • Noninvasive tests can effectively assess HCV-related lesions in HD patients.

Conclusions:

  • Antiviral therapy for Hepatitis C virus is best initiated during dialysis treatment.
  • Successful viral clearance before kidney transplantation prevents HCV relapse and liver disease progression post-transplant.
  • Noninvasive assessment of liver lesions is feasible in hemodialysis patients.

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