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Abstract Details
Hepatitis C and Treatment in Patients with Chronic Kidney Disease
Dis Mon. 2020 Jun 15;101017. doi: 10.1016/j.disamonth.2020.101017.Online ahead of print.
Abhijay Jalota1, Brian K Lindner2, Beje Thomas3, Edgar V Lerma4
Author information
1MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States. Electronic address: abhijay.jalota@gmail.com.
2MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States.
3MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States; MedStar Georgetown Transplant Insitute, 3800 Reservoir Rd NW, Washington, DC 20007, United States.
4University of Illinois at Chicago College of Medicine, 1853W Polk St, Chicago, IL 60612, United States; Advocate Christ Medical Center, 4440 W 95th St, Oak Lawn, IL 60453, United States.
Abstract
Hepatitis C virus (HCV) is associated with increased mortality and morbidity in patients with chronic kidney disease (CKD). The early detection and treatment of Hepatitis C associated with kidney disease is paramount to preventing the progressive loss of kidney function. HCV treatment until the advent of direct acting anti-viral agents (DAAs) was limited to interferon and ribavirin. Interferon and ribavirin treatment resulted in only modest success but with frequent adverse events and poor tolerability. Furthermore, interferon and ribavirin could not be used in certain patient populations including those with advanced CKD, were on dialysis, or those who have received a kidney transplant. DAAs have now made treatment possible in these sub-groups with a sustained viral response (SVR) of 90-100% and minimal side effects. DAAs have helped increase transplant rates by allowing for the use of HCV positive kidneys in recipients who are HCV negative. Although the choice of DAAs should be carefully considered and based on patient characteristics, concomitant medications, and HCV genotype.