title: Hepatitis C in Special Patient Cohorts: New Opportunities in Decompensated Liver Cirrhosis, End-Stage Renal Disease and Transplant Medicine.
abstract: Worldwide, hepatitis C virus (HCV) is a common infection. Due to new antiviral approaches and the approval of direct-acting antiviral agents (DAA), HCV therapy has become more comfortable. Nevertheless, there are special patient groups, in whom treatment of HCV is still challenging. Due to only few data available, tolerability and efficacy of DAAs in special patient cohorts still remain unclear. Such special patient cohorts comprise HCV in patients with decompensated liver disease (Child-Pugh Class B or C), patients with chronic kidney disease, and patients on waiting lists to renal/liver transplantation or those with HCV recurrence after liver transplantation. HCV infection in these patient cohorts has been shown to be associated with increased morbidity and mortality and may lead to reduced graft survival after transplantation. Successful eradication of HCV results in a better outcome concerning liver-related complications and in a better clinical outcome of these patients. In this review, we analyze available data and results from recently published literature and provide an overview of current recommendations of HCV-therapy regimen in these special patient cohorts.
authors.affiliation: Department of Transplant Medicine, University Hospital Muenster, 48149 Münster, Germany. anna.huesing@ukmuenster.de.
authors.forename: Anna
authors.initials: A
authors.lastname: Hüsing
authors.affiliation: Department of Transplant Medicine, University Hospital Muenster, 48149 Münster, Germany. iyad.kabar@ukmuenster.de.
authors.forename: Iyad
authors.initials: I
authors.lastname: Kabar
authors.affiliation: Department of Transplant Medicine, University Hospital Muenster, 48149 Münster, Germany. hepar@ukmuenster.de.
authors.forename: Hartmut H
authors.initials: HH
authors.lastname: Schmidt
authors.affiliation: Department of Transplant Medicine, University Hospital Muenster, 48149 Münster, Germany. hauke.heinzow@ukmuenster.de.
authors.forename: Hauke S
authors.initials: HS
authors.lastname: Heinzow
mesh_terms: D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015331:Cohort Studies; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D016030:Kidney Transplantation; D008103:Liver Cirrhosis / Q000150:complications*; D016031:Liver Transplantation; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000150:complications
chemical_list: D000998:Antiviral Agents
keywords: DAA treatment; HCV infection; chronic kidney disease; decompensated liver cirrhosis; liver transplantation; new therapy regimen; renal transplantation