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Hepatitis C and kidney disease: An overview and approach to management
Ahmad Najib Azmi1, Soek-Siam Tan1, Rosmawati Mohamed1
1Ahmad Najib Azmi, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur 55100, Malaysia.
Insights
Hepatitis C (HCV) infection is linked to chronic kidney disease (CKD). While new treatments show promise, their safety in severe kidney impairment requires further study.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis C infection is a global health issue with significant kidney involvement.
- A strong association exists between Hepatitis C and chronic kidney disease.
- Hemodialysis patients have a higher prevalence of Hepatitis C infection, impacting survival.
Purpose of the Study:
- To review the relationship between Hepatitis C and chronic kidney disease.
- To describe renal diseases associated with Hepatitis C.
- To discuss current and novel Hepatitis C treatments for kidney patients.
Main Methods:
- Literature review of studies on Hepatitis C and kidney disease.
- Analysis of epidemiological data on Hepatitis C in hemodialysis patients.
- Evaluation of treatment outcomes for Hepatitis C in end-stage renal disease.
Main Results:
- Hepatitis C infection negatively affects hemodialysis and transplant patient survival.
- Conventional Hepatitis C treatments show low response and tolerability in renal impairment.
- New direct-acting antivirals offer potential but require safety confirmation in severe renal impairment.
Conclusions:
- Hepatitis C poses a significant threat to kidney health and impacts renal patient outcomes.
- Existing Hepatitis C therapies are challenging for end-stage renal disease patients.
- Further research is crucial to establish the safety and efficacy of newer Hepatitis C treatments in patients with varying degrees of renal impairment.
Abstract:
Hepatitis C infection and chronic kidney disease are major health burden worldwide. Hepatitis C infection is associated with a wide range of extra-hepatic manifestations in various organs including the kidneys. A strong association between hepatitis C and chronic kidney disease has come to light. Hemodialysis in supporting the end stage renal disease patients unfortunately carries a risk for hepatitis C infection. Despite much improvement in the care of this group of patients, the prevalence of hepatitis C infection in hemodialysis patients is still higher than the general population. Hepatitis C infection has a negative effect on the survival of hemodialysis and renal transplant patients. Treatment of hepatitis C in end stage renal disease patients using conventional or pegylated interferon with or without ribavirin remains a clinical challenge with low response rate, high dropout rate due to poor tolerability and many unmet needs. The approval of new direct acting antiviral agents for hepatitis C may dramatically change the treatment approach in hepatitis C infected patients with mild to moderate renal impairment. However it remains to be confirmed if the newer Hepatitis C therapies are safe in individuals with severe renal impairment. This review article discusses the relationship between hepatitis C and chronic kidney disease, describe the various types of renal diseases associated with hepatitis C and the newer as well as the existing treatments for hepatitis C in the context of this subpopulation of hepatitis C patients.
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