[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.
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Service de transplantation, Hbopital Necker, Paris.
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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.