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Hepatitis C infection in hemodialysis patients: A review

Digdem Ozer Etik1, Serkan Ocal1, Ahmet Sedat Boyacioglu1

  • 1Digdem Ozer Etik, Serkan Ocal, Ahmet Sedat Boyacioglu, Department of Gastroenterology, Baskent University, 06000 Ankara, Turkey.

World Journal of Hepatology
|May 5, 2015
PubMed

Insights

Hepatitis C virus (HCV) infection significantly impacts patients with end-stage renal disease (ESRD). Early diagnosis and treatment of HCV before kidney transplantation (KT) improve survival rates and prevent post-transplant complications.

Area of Science:

  • Nephrology
  • Hepatology
  • Virology

Background:

  • Hepatitis C virus (HCV)-related liver disease is a major cause of death in end-stage renal disease (ESRD) patients undergoing dialysis or kidney transplantation (KT).
  • HCV-infected renal transplant recipients have a better survival rate than those on dialysis waiting lists.
  • Early diagnosis and treatment of HCV before KT are crucial for preventing post-transplant complications and reducing mortality.

Purpose of the Study:

  • To review the significance of HCV infection in ESRD patients.
  • To evaluate diagnostic and treatment strategies for HCV in ESRD patients.
  • To discuss the implications of HCV treatment on KT outcomes.

Main Methods:

  • Review of existing literature on HCV in ESRD patients.
  • Discussion of diagnostic methods including anti-HCV antibodies, HCV RNA, and liver biopsy for fibrosis staging.
  • Analysis of treatment options such as interferon monotherapy and combination therapy with ribavirin.

Main Results:

  • Conventional and pegylated interferon monotherapy show similar efficacy and safety in HCV-infected hemodialysis patients, with sustained viral responses (SVRs) around 30-40%.
  • Combination therapy with interferon and ribavirin is supported by limited reports for ESRD patients, requiring careful monitoring.
  • Patients achieving SVR are strong candidates for KT.

Conclusions:

  • Early and effective management of HCV infection in ESRD patients is vital for improving outcomes, particularly for those awaiting or undergoing KT.
  • Liver biopsy is valuable for staging fibrosis and guiding treatment decisions.
  • ESRD patients with advanced liver disease may benefit from combined liver-KT evaluation.

Keywords:
End-stage renal diseaseHemodialysisHepatitis C treatmentHepatitis C virusKidney transplantation

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