Hepatitis B and hepatitis C virus and chronic kidney disease

F. Fabrizi, P. Martin, P. Messa

Research output: Contribution to journalArticlepeer-review

Abstract

The most common cause of liver disease in patients with chronic kidney disease (CKD) remains infection by hepatitis B virus (HBV) and/or hepatitis C virus (HCV). The adverse effects of HBV and/or HCV infections upon survival in patients with CKD have been repeatedly confirmed. An excess risk of death in HBsAg positive or anti-HCV antibody-positive patients may be at least partially attributed to chronic liver disease with its attendant complications. A negative impact of HCV infection on survival after renal transplantation has been linked to extrahepatic complications, including chronic glomerulonephritis, sepsis, chronic allograft nephropathy, post-transplantation diabetes mellitus, and abnormal metabolism of calcineurin-inhibitors. Transmission of HCV infection by grafts from HCV-infected donors has been unequivocally demonstrated. Registry analyses suggest that recipients of kidneys from anti-HCV antibody positive donors are at increased risk of mortality. Renal grafts from HCV-infected donors should be restricted to viremic anti-HCV positive recipients. Several drugs have been recently licensed for therapy of HBV infection but available data in patients with CKD is mostly limited to experience with lamivudine. The standard of care for hepatitis C infection in patients on regular dialysis is monotherapy with conventional interferon, according to recent guidelines. Only dire circumstances justify interferon use after renal transplantation. (Acta gastro enterol. belg., 2010, 73, 465-471).

Original languageEnglish
Pages (from-to)465-471
Number of pages7
JournalActa Gastro-Enterologica Belgica
Volume73
Issue number4
Publication statusPublished - Oct 2010

Keywords

  • Chronic kidney disease
  • Dialysis
  • Hepatitis b virus
  • Hepatitis c virus
  • Kidney transplantation

ASJC Scopus subject areas

  • Gastroenterology

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