title: HCV and the kidney.
abstract: Chronic hepatitis C (CHC) is significantly associated with a risk of renal deterioration over time. Renal impairment, especially stage 4-5 chronic kidney disease, increases the risk of: (i) the prevalence and incidence (in dialysis/transplantation) of hepatitis C virus (HCV) infection; (ii) liver deterioration during kidney transplantation and (iii) allograft failure and patient mortality. HCV-infected dialysis patients have a higher mortality than non-infected dialysis patients and than HCV-infected kidney recipients. The harmful impact of HCV emphasizes the need for oral antiviral therapies in patients with chronic kidney disease. Symptomatic cryoglobulinemic vasculitis and extensive liver fibrosis are already approved indications for early access to oral antiviral treatment. Patients with stage 4-5 chronic kidney disease should also be given priority: dialysis patients (whatever the stage of fibrosis and whether or not they are candidates for kidney transplantation) as well as all kidney recipients. The results of treatment of HCV with direct-acting antiviral (DAAs) drugs in patients with late chronic kidney disease are excellent, similar to those in the general population, although additional clinical trials are definitely needed, particularly to optimize adjustment of treatment to kidney function and determine the risk of drug-drug interactions.
authors.affiliation: Hepatology Department, Université Paris Descartes, Cochin Hospital, APHP, Paris, France.|INSERM U818 and UMS-20, Institut Pasteur, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Corouge
authors.affiliation: Hepatology Department, Université Paris Descartes, Cochin Hospital, APHP, Paris, France.|INSERM U818 and UMS-20, Institut Pasteur, Paris, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet-Pichard
authors.affiliation: Hepatology Department, Université Paris Descartes, Cochin Hospital, APHP, Paris, France.|INSERM U818 and UMS-20, Institut Pasteur, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D006435:Renal Dialysis / Q000379:methods
chemical_list: D000998:Antiviral Agents
keywords: dialysis; direct-acting antiviral drug; hepatitis C; kidney disease