Treating Hepatitis C in Patients with Renal Failure

Lens, Sabela; Rodriguez-Tajes, Sergio; Llovet, Laura-Patricia; Maduell, Francisco; Londoño, Maria-Carlota
May 2017
Digestive Diseases;May2017, Vol. 35 Issue 4, p339
Academic Journal
Background: There is a strong relationship between hepatitis C virus (HCV) infection and the kidney. Approximately 10-16% of the patients with HCV infection develop renal disease, and the prevalence of HCV infection in patients with renal dysfunction is higher than that of the general population (9.5 vs. 1.6%). Moreover, HCV-positive patients on hemodialysis (HD) have higher mortality rates as compared to HCV-negative patients also on HD, not only due to liverrelated complications but also owing to cardiovascular disease. Key Messages: In the interferon era, the treatment of HCV infection in patients on HD was hampered due to a significant number of treatment-related adverse events (predominately anemia and infectious complications). The development of direct-acting antivirals (DAAs) has revolutionized the field allowing viral eradication in these very sick patients. Two recently published clinical trials assessed the efficacy and safety of DAAs in patients with end-stage renal disease (ESRD). The combination of grazoprevir and elbasvir has been studied in the C-SURFER trial with 94% of the patients achieving sustained virological response (SVR). Adverse events were mild and only a small number of patients discontinued therapy early due to adverse events. The 3D regimen was evaluated in the RUBY-I trial. Here, a 90% SVR rate was achieved in 20 patients with ESRD, most of them on HD. Although sofosbuvir is eliminated by the kidney and its use in patients with glomerular filtration rate <30 mL/min is not recommended, real-life data have shown good results for this drug in terms of efficacy and safety. Conclusions: The use of DAAs has safely permitted the treatment of patients with renal dysfunction with excellent efficacy results.


Related Articles

  • Hepatitis C in dialysis units. Quiroz, Rolando José Ortega // Revista Colombiana de Gastroenterología;Mar2010, Vol. 25 Issue 1, p4 

    The author reflects on the treatment of Hepatitis C virus (HCV) in dialysis units. He considers the amount of time a patient spends in hemodialysis units as the primary risk factor for Hepatitis C infection acquisition. He points out that HCV's natural history in patients with chronic renal...

  • Evidence of association between hepatitis C virus genotype 2b and nosocomial transmissions in hemodialysis centers from southern Brazil. da Silva, Naylê Maria Oliveira; Germano, Fabiana Nunes; Mendoza-Sassi, Raul Andres; Seuánez, Hector Nicolas; Soares, Marcelo Alves; de Martinez, Ana Maria Barral // Virology Journal;2013, Vol. 10 Issue 1, p1 

    Background: Hepatitis C virus infection is a serious public health problem. Hemodialysis is considered one of the main risk factors of HCV infection, due to several invasive medical procedures and potential nosocomial transmission that patients with chronic renal failure (CRF) are continuously...

  • Prevalence of HCV infection in patients on haemodialysis: survey by antibody and core antigen detection. Reddy, A. K.; Murthy, K. V. D.; Lakshmi, V. // Indian Journal of Medical Microbiology;Apr2005, Vol. 23 Issue 2, p106 

    Purpose: The present study was undertaken to determine the prevalence of HCV infection by antibody testing and HCV core antigen (HCVcAg) determination by ELISA in haemodialysis patients and to evaluate the HCV c Ag assay in the detection of HCV infected patients on...

  • Utility of HCV core antigen ELISA in the screening for hepatitis C virus infection in patients on hemodialysis. Reddy, A. K.; Dakshinamurty, K. V.; Lakshmi, V. // Indian Journal of Medical Microbiology;Jan2006, Vol. 24 Issue 1, p55 

    An enzyme immuno assay for hepatitis C core antigen was recently developed and its performance was compared with that of the hepatitis C virus (HCV) RNA in the screening of HCV infection in patients on hemodialysis. One hundred and eleven chronic renal failure patients undergoing haemodialysis...

  • The Comparision of Hepatitis C Virus (HCV) Core Antigen and HCV RNA Levels for Diagnosis of HCV Infection in Haemodialysis Patients. Kizilates, Filiz; Cekin, Yesim; Sari, Funda; Sarikaya, Metin; Seyman, Derya; Oztoprak, Nefise; Cetinkaya, Ramazan // HealthMed;2013, Vol. 7 Issue 8, p2395 

    The diagnosis and monitoring of HCV infection are commonly based on anti-HCV assays. But anti-HCV assays indicate only the exposure of virus therefore confirmation with nucleic acid amplification assays is supposed. Architect HCV Ag assay is recently developed for detecting HCV nucleocapsid...

  • Utility of routine real time quantitative PCR monitoring of HCV infection in haemodialysis patients. Datta, S.; Goel, N.; Wattal, C. // Indian Journal of Medical Microbiology;2015 Supplement 1, Vol. 33, pS106 

    Background: Hepatitis C virus (HCV) infection causes significant morbidity and mortality in patients of end stage renal disease (ESRD) on haemodialysis (HD). Stringent screening methods can help in its early diagnosis. Objective: The study addresses the utility of real-time quantitative...

  • Prevalencia de anticuerpos contra el virus de hepatitis C en unidades de diálisis de Cali-Colombia. Ramírez, Roberto; Fernández, Julián; Guevara, Juan Guillermo; Valderrama, Luis Alfonso; Castro, Adolfo León; Álvarez, Javier Arango; Holguín, R. Jaime // Revista Colombiana de Gastroenterología;Mar2010, Vol. 25 Issue 1, p14 

    The prevalence of anti-HCV antibodies among patients on dialysis is consistently higher than in healthy populations, suggesting that dialysis patients may be at higher risk of acquiring HCV infection. The aim of our study was to determinate the prevalence of anti-HCV antibodies in patients whom...

  • NEW APPROACHES IN THE THERAPY OF HEPATITIS C IN DIALYSIS PATIENTS. Sikole, A.; Dzekova, P.; Asani, A.; Amitov, V.; Selim, Gj.; Gelev, S.; Polenakovic, M. // Contributions of Macedonian Academy of Sciences & Arts;2008, Vol. 29 Issue 2, p155 

    Patients with renal disease are at increased risk of acquiring hepatitis C virus (HCV) infection because of their frequent exposure to blood from transfusions or exposure to HCV-contaminated medical equipment during hemodialysis. The prevalence of anti-HCV antibodies among hemodialysis patients...

  • Pegylated Interferon Alfa-2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C. Chen-Hua Liu; Cheng-Chao Liang; Chun-Jen Liu; Jou-Wei Lin; Shih-I Chen; Peir-Haur Hung; Hung-Bin Tsai; Ming-Yang Lai; Pei-Jer Chen; Ding-Shinn Chen; Jia-Horng Kao // Clinical Infectious Diseases;9/1/2010, Vol. 51 Issue 5, p541 

    Background. Hemodialysis patients are at risk of hepatitis C virus (HCV) infection. However, little is known about the efficacy and safety of pegylated interferon (IFN) therapy for hemodialysis patients with acute hepatitis C. Methods. From 2005 through 2008, 35 hemodialysis patients with acute...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics