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ESRD patients coinfected with human immunodeficiency virus and Hepatitis C: Outcomes and management challenges
Author(s) -
Sawinski Deirdre
Publication year - 2018
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12765
Subject(s) - medicine , immunosuppression , hepatitis c , dialysis , kidney disease , hepatitis c virus , intensive care medicine , population , kidney transplantation , disease , immunology , human immunodeficiency virus (hiv) , transplantation , virus , environmental health
HIV infection is a major public health problem worldwide. Due to shared modes of acquisition, many HIV + patients are coinfected with Hepatitis C. HIV/HCV coinfected patients have an increased burden of chronic kidney disease and are more likely to progress to end‐stage renal disease. Dialysis survival is diminished in the coinfected population, even in the contemporary era. Kidney transplantation offers a survival benefit over remaining on dialysis; however, posttransplant outcomes are inferior compared to patients with HIV infection alone. Direct acting antiviral agents may offer an opportunity to improve patient survival, but there are significant drug‐drug interactions involving the direct acting antiviral agents, antiretroviral therapy, and immunosuppression that the clinician should be aware of.