[Viral hepatitis in hemodialysis and renal transplantation patients].
In patients with chronic renal failure be they hemodialysed or transplanted, viral hepatitis B and C tend to progress towards chronicity, in spite of both a frequent silent clinical presentation and an atypical course of viral markers. Therefore, only liver biopsy will allow a precise diagnosis of liver disease in these patients. Immunosuppression clearly modifies natural history of B and C viral hepatitis, but their real impact at mid and long-term on patient survival is still a matter of debate. Treatment is firstly preventive (vaccination and isolation of infected patients in dialysis units) and secondly curative. Preliminary data suggest that antiviral drugs such as ARA-AMP and interferon-alpha may have the same efficacy as in non-immunosuppressed patients. It is therefore of urgent need to evaluate both efficacy and tolerance of these antiviral drugs in patients on hemodialysis and in kidney transplant recipients.
Service de transplantation, Hbopital Necker, Paris.
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Legendre
D000206:Actuarial Analysis; D000998:Antiviral Agents / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects; D008099:Liver / Q000473:pathology; D011183:Postoperative Complications; D015995:Prevalence; D006435:Renal Dialysis; D016019:Survival Analysis; D065227:Transfusion Reaction; D014775:Virus Activation
D000998:Antiviral Agents; D017325:Hepatitis B Vaccines
Les hépatites virales chez les patients hémodialysés et transplantés rénaux.