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Hepatitis C virus infection in haemodialysis and kidney transplant patients
Author(s) -
BaidAgrawal Seema,
Pascual Manuel,
Moradpour Darius,
Frei Ulrich,
TolkoffRubin Nina
Publication year - 2007
Publication title -
reviews in medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.06
H-Index - 90
eISSN - 1099-1654
pISSN - 1052-9276
DOI - 10.1002/rmv.565
Subject(s) - medicine , contraindication , transplantation , dialysis , ribavirin , hepatitis c , kidney transplantation , pegylated interferon , population , hepatitis c virus , kidney disease , immunology , gastroenterology , virus , pathology , alternative medicine , environmental health
Chronic infection with hepatitis C virus (HCV) is an important global health problem. The prevalence of HCV is significantly higher in haemodialysis and kidney transplant patients, as compared to the general population. In spite of the relatively milder liver disease activity reported in HCV‐infected haemodialysis patients, HCV infection adversely affects survival. Likewise, HCV has a detrimental effect on both patient and graft survival after kidney transplantation. However, patient survival is significantly better with kidney transplantation compared to remaining on dialysis; therefore, HCV infection alone should not be a contraindication to transplantation. Combination antiviral therapy with pegylated interferon‐alpha and low‐dose ribavirin is currently evolving in haemodialysis patients. Interferon‐alpha (standard/pegylated) is relatively contraindicated after kidney transplantation because of an increased risk of allograft rejection. Therefore, antiviral treatment of transplant candidates while on dialysis remains the best option and may avoid the risk of HCV‐associated liver and renal disease after transplantation. Large multi‐centre clinical trials are required in HCV‐infected haemodialysis and kidney transplant patients in order to define optimal therapeutic strategies before and after transplantation. Copyright © 2007 John Wiley & Sons, Ltd.