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http://dx.doi.org/10.3904/kjim.2018.202

Hepatitis C virus infection in chronic kidney disease: paradigm shift in management  

Kim, So Mi (Division of Nephrology, Department of Internal Medicine, Dankook University Hospital)
Song, Il Han (Division of Hepatology, Department of Internal Medicine, Dankook University Hospital)
Publication Information
The Korean journal of internal medicine / v.33, no.4, 2018 , pp. 670-678 More about this Journal
Abstract
Hepatitis C virus (HCV) infection in chronic kidney disease (CKD) is associated with increased liver-related morbidity and mortality rates, accelerated progression to end-stage renal disease, and risk of cardiovascular events. CKD patients with HCV infection require antiviral therapy. Pegylated interferon (peg-IFN) plus ribavirin was the standard of care for HCV-infected CKD patients before the introduction of first-generation direct-acting antiviral (DAA) oral anti-HCV agents. Peg-IFN-based treatment has a low virologic response rate and poor compliance, resulting in a high dropout rate. Recently, several clinical trials of all-DAA combination regimens have reported excellent antiviral efficacy and few adverse drug reactions in HCV-infected patients with CKD. These positive results have revolutionized the treatment of chronic HCV infection in this population. In this review, we address the impact of chronic HCV infection in CKD patients, and discuss their management using next-generation DAAs.
Keywords
Hepatitis C virus; Renal insufficiency, chronic; Kidney transplantation; Direct-acting agents;
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