Management of hepatitis C in patients with chronic kidney disease

Detalhes bibliográficos
Autor(a) principal: Carvalho-Filho, Roberto José de [UNIFESP]
Data de Publicação: 2015
Outros Autores: Feldner, Ana Cristinade Castro Amaral [UNIFESP], Silva, Antonio Eduardo Benedito [UNIFESP], Ferraz, Maria Lucia G. [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.3748/wjg.v21.i2.408
http://repositorio.unifesp.br/handle/11600/38636
Resumo: Hepatitis C virus (HCV) infection is highly prevalent among chronic kidney disease (CKD) subjects under hemodialysis and in kidney transplantation (KT) recipients, being an important cause of morbidity and mortality in these patients. the vast majority of HCV chronic infections in the hemodialysis setting are currently attributable to nosocomial transmission. Acute and chronic hepatitis C exhibits distinct clinical and laboratorial features, which can impact on management and treatment decisions. in hemodialysis subjects, acute infections are usually asymptomatic and anicteric; since spontaneous viral clearance is very uncommon in this context, acute infections should be treated as soon as possible. in KT recipients, the occurrence of acute hepatitis C can have a more severe course, with a rapid progression of liver fibrosis. in these patients, it is recommended to use pegylated interferon (PEG-IFN) in combination with ribavirin, with doses adjusted according to estimated glomerular filtration rate. There is no evidence suggesting that chronic hepatitis C exhibits a more aggressive course in CKD subjects under conservative management. in these subjects, indication of treatment with PEG-IFN plus ribavirin relies on the CKD stage, rate of progression of renal dysfunction and the possibility of a preemptive transplant. HCV infection has been associated with both liver disease-related deaths and cardiovascular mortality in hemodialysis patients. Among those individuals, low HCV viral loads and the phenomenon of intermittent HCV viremia are often observed, and sequential HCV RNA monitoring is needed. Despite the poor tolerability and suboptimal efficacy of antiviral therapy in CKD patients, many patients can achieve sustained virological response, which improve patient and graft outcomes. Hepatitis C eradication before KT theoretically improves survival and reduces the occurrence of chronic graft nephropathy, de novo glomerulonephritis and post-transplant diabetes mellitus.
id UFSP_3140d83b2f723abe02a2abc41af66371
oai_identifier_str oai:repositorio.unifesp.br/:11600/38636
network_acronym_str UFSP
network_name_str Repositório Institucional da UNIFESP
repository_id_str 3465
spelling Management of hepatitis C in patients with chronic kidney diseaseHepatitis C virusChronic kidney diseaseEnd-stage renal diseaseHemodialysisKidney transplantationDiagnosisConservative managementTherapyHepatitis C virus (HCV) infection is highly prevalent among chronic kidney disease (CKD) subjects under hemodialysis and in kidney transplantation (KT) recipients, being an important cause of morbidity and mortality in these patients. the vast majority of HCV chronic infections in the hemodialysis setting are currently attributable to nosocomial transmission. Acute and chronic hepatitis C exhibits distinct clinical and laboratorial features, which can impact on management and treatment decisions. in hemodialysis subjects, acute infections are usually asymptomatic and anicteric; since spontaneous viral clearance is very uncommon in this context, acute infections should be treated as soon as possible. in KT recipients, the occurrence of acute hepatitis C can have a more severe course, with a rapid progression of liver fibrosis. in these patients, it is recommended to use pegylated interferon (PEG-IFN) in combination with ribavirin, with doses adjusted according to estimated glomerular filtration rate. There is no evidence suggesting that chronic hepatitis C exhibits a more aggressive course in CKD subjects under conservative management. in these subjects, indication of treatment with PEG-IFN plus ribavirin relies on the CKD stage, rate of progression of renal dysfunction and the possibility of a preemptive transplant. HCV infection has been associated with both liver disease-related deaths and cardiovascular mortality in hemodialysis patients. Among those individuals, low HCV viral loads and the phenomenon of intermittent HCV viremia are often observed, and sequential HCV RNA monitoring is needed. Despite the poor tolerability and suboptimal efficacy of antiviral therapy in CKD patients, many patients can achieve sustained virological response, which improve patient and graft outcomes. Hepatitis C eradication before KT theoretically improves survival and reduces the occurrence of chronic graft nephropathy, de novo glomerulonephritis and post-transplant diabetes mellitus.Universidade Federal de São Paulo, Div Gastroenterol, Hepatol Sect, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, Hepatol Sect, BR-04023900 São Paulo, BrazilWeb of ScienceBaishideng Publishing Group IncUniversidade Federal de São Paulo (UNIFESP)Carvalho-Filho, Roberto José de [UNIFESP]Feldner, Ana Cristinade Castro Amaral [UNIFESP]Silva, Antonio Eduardo Benedito [UNIFESP]Ferraz, Maria Lucia G. [UNIFESP]2016-01-24T14:39:54Z2016-01-24T14:39:54Z2015-01-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion408-422http://dx.doi.org/10.3748/wjg.v21.i2.408World Journal of Gastroenterology. Pleasanton: Baishideng Publishing Group Inc, v. 21, n. 2, p. 408-422, 2015.10.3748/wjg.v21.i2.4081007-9327http://repositorio.unifesp.br/handle/11600/38636WOS:000348419200004engWorld Journal of Gastroenterologyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2023-03-27T16:28:17Zoai:repositorio.unifesp.br/:11600/38636Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652023-03-27T16:28:17Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Management of hepatitis C in patients with chronic kidney disease
title Management of hepatitis C in patients with chronic kidney disease
spellingShingle Management of hepatitis C in patients with chronic kidney disease
Carvalho-Filho, Roberto José de [UNIFESP]
Hepatitis C virus
Chronic kidney disease
End-stage renal disease
Hemodialysis
Kidney transplantation
Diagnosis
Conservative management
Therapy
title_short Management of hepatitis C in patients with chronic kidney disease
title_full Management of hepatitis C in patients with chronic kidney disease
title_fullStr Management of hepatitis C in patients with chronic kidney disease
title_full_unstemmed Management of hepatitis C in patients with chronic kidney disease
title_sort Management of hepatitis C in patients with chronic kidney disease
author Carvalho-Filho, Roberto José de [UNIFESP]
author_facet Carvalho-Filho, Roberto José de [UNIFESP]
Feldner, Ana Cristinade Castro Amaral [UNIFESP]
Silva, Antonio Eduardo Benedito [UNIFESP]
Ferraz, Maria Lucia G. [UNIFESP]
author_role author
author2 Feldner, Ana Cristinade Castro Amaral [UNIFESP]
Silva, Antonio Eduardo Benedito [UNIFESP]
Ferraz, Maria Lucia G. [UNIFESP]
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Carvalho-Filho, Roberto José de [UNIFESP]
Feldner, Ana Cristinade Castro Amaral [UNIFESP]
Silva, Antonio Eduardo Benedito [UNIFESP]
Ferraz, Maria Lucia G. [UNIFESP]
dc.subject.por.fl_str_mv Hepatitis C virus
Chronic kidney disease
End-stage renal disease
Hemodialysis
Kidney transplantation
Diagnosis
Conservative management
Therapy
topic Hepatitis C virus
Chronic kidney disease
End-stage renal disease
Hemodialysis
Kidney transplantation
Diagnosis
Conservative management
Therapy
description Hepatitis C virus (HCV) infection is highly prevalent among chronic kidney disease (CKD) subjects under hemodialysis and in kidney transplantation (KT) recipients, being an important cause of morbidity and mortality in these patients. the vast majority of HCV chronic infections in the hemodialysis setting are currently attributable to nosocomial transmission. Acute and chronic hepatitis C exhibits distinct clinical and laboratorial features, which can impact on management and treatment decisions. in hemodialysis subjects, acute infections are usually asymptomatic and anicteric; since spontaneous viral clearance is very uncommon in this context, acute infections should be treated as soon as possible. in KT recipients, the occurrence of acute hepatitis C can have a more severe course, with a rapid progression of liver fibrosis. in these patients, it is recommended to use pegylated interferon (PEG-IFN) in combination with ribavirin, with doses adjusted according to estimated glomerular filtration rate. There is no evidence suggesting that chronic hepatitis C exhibits a more aggressive course in CKD subjects under conservative management. in these subjects, indication of treatment with PEG-IFN plus ribavirin relies on the CKD stage, rate of progression of renal dysfunction and the possibility of a preemptive transplant. HCV infection has been associated with both liver disease-related deaths and cardiovascular mortality in hemodialysis patients. Among those individuals, low HCV viral loads and the phenomenon of intermittent HCV viremia are often observed, and sequential HCV RNA monitoring is needed. Despite the poor tolerability and suboptimal efficacy of antiviral therapy in CKD patients, many patients can achieve sustained virological response, which improve patient and graft outcomes. Hepatitis C eradication before KT theoretically improves survival and reduces the occurrence of chronic graft nephropathy, de novo glomerulonephritis and post-transplant diabetes mellitus.
publishDate 2015
dc.date.none.fl_str_mv 2015-01-14
2016-01-24T14:39:54Z
2016-01-24T14:39:54Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.3748/wjg.v21.i2.408
World Journal of Gastroenterology. Pleasanton: Baishideng Publishing Group Inc, v. 21, n. 2, p. 408-422, 2015.
10.3748/wjg.v21.i2.408
1007-9327
http://repositorio.unifesp.br/handle/11600/38636
WOS:000348419200004
url http://dx.doi.org/10.3748/wjg.v21.i2.408
http://repositorio.unifesp.br/handle/11600/38636
identifier_str_mv World Journal of Gastroenterology. Pleasanton: Baishideng Publishing Group Inc, v. 21, n. 2, p. 408-422, 2015.
10.3748/wjg.v21.i2.408
1007-9327
WOS:000348419200004
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv World Journal of Gastroenterology
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 408-422
dc.publisher.none.fl_str_mv Baishideng Publishing Group Inc
publisher.none.fl_str_mv Baishideng Publishing Group Inc
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
_version_ 1814268454600966144