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End-Stage Renal Disease and Treatment of Hepatitis C Virus Infection

  • Hepatitis C (A Aronsohn and H Vargas, Section Editors)
  • Published:
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Abstract

Purpose of Review

The prevalence of hepatitis C virus (HCV) infection is higher among patients with chronic kidney disease and end-stage renal failure when compared to the general population. Patients with HCV infection and kidney dysfunction have been shown to have an increased morbidity and mortality in part due to multiple extra-hepatic complications including lymphoma, an increase in cardiovascular events, insulin resistance, and a more rapid progression of chronic kidney disease to end-stage renal failure. This review will summarize the current data on the use of the direct acting antivirals (DAA) in patients with more advanced kidney disease.

Recent Findings

Historically, HCV infection in patients with chronic kidney disease (CKD) has presented a difficult therapeutic challenge due to the unacceptable side effects associated with the interferon-based protocols. The introduction of the DAAs has dramatically altered the outcomes and tolerability associated with HCV treatment in the general population and made cure a reasonable expectation with sustained viral response (SVR) rates exceeding 90% in the large phase 3 trials. With the success achieved in the general population, the focus has shifted to more difficult to treat populations including patients with CKD and end-stage renal disease (ESRD). Several trials have studied DAA use in this group of patients and offered a better understanding of appropriate drug usage and expected outcomes.

Summary

Safe and effective antiviral therapy for HCV-infected CKD and ESRD patients is now available. Decisions regarding which patients should be treated and the most appropriate time to offer therapy are now of primary importance.

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Authors and Affiliations

  1. Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, 1120 NW 14th Street, Room 813, Miami, FL, 33136, USA

    Javier A. Pagan, Marco Ladino & David Roth

  2. Miami Veterans Administration Medical Center, Miami, FL, USA

    Marco Ladino

Authors
  1. Javier A. Pagan
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  2. Marco Ladino
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Correspondence to David Roth.

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Conflict of Interest

David Roth reports serving on the Scientific Advisory Board for Merck Co. and for Abbvie.

Javier A. Pagan and Marco Ladino each declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hepatitis C

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Pagan, J.A., Ladino, M. & Roth, D. End-Stage Renal Disease and Treatment of Hepatitis C Virus Infection. Curr Hepatology Rep 17, 78–82 (2018). https://doi.org/10.1007/s11901-018-0387-9

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  • DOI: https://doi.org/10.1007/s11901-018-0387-9

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