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Hepatitis C in hemodialysis patients
Smaragdi Marinaki1, John N Boletis1, Stratigoula Sakellariou1
1Smaragdi Marinaki, John N Boletis, Department of Nephrology and Renal Transplantation Unit, Medical School, University of Athens, Laiko General Hospital, 11527 Athens, Greece.
World Journal of Hepatology
|April 8, 2015
Summary
Hepatitis C virus (HCV) infection in hemodialysis patients presents milder liver disease but increased mortality. Treatment involves interferon-based therapies, with new options like protease inhibitors emerging.
Area of Science:
- Hepatology
- Nephrology
- Virology
Background:
- Hepatitis C virus (HCV) remains a concern for hemodialysis (HD) patients despite reduced prevalence.
- HD patients exhibit a unique, milder clinical course of HCV infection compared to the general population.
Purpose of the Study:
- To understand the natural history and clinical outcomes of HCV infection in hemodialysis patients.
- To explore potential explanations for the altered HCV disease course in this population.
- To review current and emerging therapeutic strategies for HCV in HD patients.
Main Methods:
- Review of existing literature on HCV in hemodialysis.
- Analysis of clinical outcomes, viral kinetics, and histological findings.
- Evaluation of treatment efficacy and safety data for interferon-based therapies and novel agents.
Main Results:
- HD patients demonstrate lower aminotransferase and viral levels, with milder liver histology.
- HCV infection in HD patients is associated with slower progression, reduced cirrhosis/HCC rates, but higher mortality.
- Interferon-based treatments yield sustained viral response in 30-40%, with significant withdrawal rates.
Conclusions:
- HCV in HD patients has a distinct natural history, potentially influenced by uremia and dialysis.
- Therapy is recommended for select patients, particularly transplant candidates.
- Combination therapies and protease inhibitors show promise for improved outcomes.
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