Hepatitis C virus infection and kidney transplantation in 2014: what's new?

Area of Science:

• Nephrology
• Hepatology
• Transplantation Immunology

Background:

• Chronic hepatitis C virus (HCV) infection presents significant risks for kidney transplant recipients, affecting both patient and allograft survival.
• Despite complications, HCV infection is not an absolute contraindication for kidney transplantation, as survival rates exceed those on dialysis.
• Extrahepatic manifestations of HCV infection contribute to adverse outcomes in this vulnerable population.

Purpose of the Study:

• To review the current understanding of managing chronic hepatitis C virus (HCV) infection in kidney transplant recipients.
• To discuss the efficacy and safety of existing and emerging antiviral therapies in the context of kidney transplantation.
• To highlight areas requiring further research, including optimal immunosuppression and donor selection.

Main Methods:

• Review of existing literature on HCV infection in kidney transplant recipients.
• Analysis of current treatment strategies, including interferon-based and interferon-free regimens.
• Discussion of transplantation considerations, such as donor selection and combined organ transplantation.

Main Results:

• Interferon-alpha (IFN-α) based treatments are associated with increased renal allograft rejection rates.
• Interferon-free treatment regimens demonstrate higher efficacy and reduced toxicity, representing promising options post-transplantation.
• Further clinical trials are essential to evaluate novel regimens and optimal immunosuppressive strategies in kidney recipients.

Conclusions:

• Kidney transplantation offers better survival than dialysis for HCV-infected patients.
• Antiviral treatment prior to transplantation is preferred; interferon-free regimens are promising post-transplantation but require further study.
• Careful consideration of donor type and immunosuppression is crucial for HCV-infected kidney transplant recipients.