Korean J Intern Med.  2018 Jul;33(4):670-678. 10.3904/kjim.2018.202.

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

• Kim SM
• Song IH

• KMID: 2415992
• DOI: http://doi.org/10.3904/kjim.2018.202

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.

Keyword

Hepatitis C virus; Renal insufficiency, chronic; Kidney transplantation; Direct-acting agents

MeSH Terms

Compliance
Drug-Related Side Effects and Adverse Reactions
Hepacivirus*
Hepatitis C*
Hepatitis*
Humans
Interferons
Kidney Failure, Chronic
Kidney Transplantation
Mortality
Renal Insufficiency, Chronic*
Ribavirin
Standard of Care
Interferons
Ribavirin