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Hepatitis C infection is very rarely treated among hemodialysis patients

David A Goodkin1, Brian Bieber, Brenda Gillespie

  • 1Arbor Research Collaborative for Health, Ann Arbor, Mich., USA.

American Journal of Nephrology
|November 7, 2013
PubMed

Insights

Hepatitis C virus (HCV) infection treatment is rare in hemodialysis patients. Antiviral therapy may improve survival, especially for those awaiting kidney transplants.

Area of Science:

  • Nephrology
  • Hepatology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection increases mortality in hemodialysis (HD) patients.
  • Treatment guidelines recommend HCV therapy for HD patients awaiting transplantation.
  • Case-by-case decisions guide treatment for other infected HD patients.

Purpose of the Study:

  • To evaluate the extent and outcomes of HCV therapy in hemodialysis patients.
  • To assess the impact of antiviral treatment on mortality in this population.

Main Methods:

  • Observational study using Dialysis Outcomes and Practice Patterns data (1996-2011).
  • Included 49,762 HD patients across 12 nations.
  • Analyzed HCV status, antiviral medication use (interferon/ribavirin), and survival.

Main Results:

  • 9.5% of HD patients were HCV+. Only 1.0% received antiviral therapy.
  • Among HCV+ patients awaiting kidney transplants, only 3.7% received treatment.
  • Adjusted mortality hazard ratio for treated vs. untreated patients was 0.47 (95% CI, 0.17-1.26).

Conclusions:

  • Antiviral therapy for HCV in hemodialysis patients is underutilized.
  • Increased HCV treatment could prolong survival, particularly for kidney transplant candidates.
Abstract

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