Hepatitis C infection and the patient with end-stage renal disease

Fabrizio Fabrizi, F. Fred Poordad, Paul Martin

Research output: Contribution to journalArticle

252 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) remains common in patients with end-stage renal disease (ESRD) and is an important cause of liver disease in this population. Acquisition of HCV infection continues to occur in dialysis patients because of nosocomial spread. The natural history of HCV in dialysis patients remains controversial because the course of HCV typically extends over decades, whereas dialysis patients have higher morbidity and mortality rates than those of the general population limiting long-term follow-up. However, recent reports suggest that HCV infection affects the survival of chronic dialysis patients as well as renal transplant (RT) recipients. The severity of preexisting liver disease on pretransplantation liver biopsy may provide useful prognostic information about clinical outcome after RT; liver biopsy should be incorporated in the evaluation and management of RT candidates with HCV. Recent surveys with long-term follow-up have documented adverse effects of HCV on patient and graft survival. Use of renal grafts from HCV-infected donors in recipients with HCV does not appear to result in a greater burden of liver disease albeit with short-term follow-up. There is only limited data about interferon (IFN) therapy in chronic dialysis patients, although sustained responses are reported. Preliminary data on IFN plus ribavirin therapy in dialysis patients with hepatitis C have given encouraging results, but randomized trials are needed. Interferon remains contraindicated post-RT because of concern about precipitating graft dysfunction.

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalHepatology
Volume36
Issue number1
DOIs
Publication statusPublished - 2002

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Hepatitis C
Hepacivirus
Chronic Kidney Failure
Dialysis
Infection
Transplants
Kidney
Interferons
Liver Diseases
Virus Diseases
Biopsy
Preexisting Condition Coverage
Ribavirin
Liver
Graft Survival
Natural History
Population
Tissue Donors
Morbidity
Survival

ASJC Scopus subject areas

  • Hepatology

Cite this

Hepatitis C infection and the patient with end-stage renal disease. / Fabrizi, Fabrizio; Poordad, F. Fred; Martin, Paul.

In: Hepatology, Vol. 36, No. 1, 2002, p. 3-10.

Research output: Contribution to journalArticle

Fabrizi, Fabrizio ; Poordad, F. Fred ; Martin, Paul. / Hepatitis C infection and the patient with end-stage renal disease. In: Hepatology. 2002 ; Vol. 36, No. 1. pp. 3-10.
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