title: An update on the management of hepatitis C virus-infected patients with stage 4-5 chronic kidney disease while awaiting the revised KDIGO Guidelines.
abstract: The treatment of hepatitis C virus (HCV) infection has progressed markedly over the last 2 decades, with a dramatic acceleration the last 3 years. The combination of two or three direct-acting antiviral drugs (DAAs) targeting viral proteins [NS3/4A protease inhibitors, NS5B nucleos(t)idic and non-nucleos(t)idic polymerase inhibitors, NS5A replication complex inhibitors], with or without ribavirin but without interferon (interferon-free regimen), for 8-24 weeks, achieved high sustained virological response (>90%), whatever fibrosis stage, genotype and subtype, baseline viral load, prior therapeutic history of the patient (naïve or experienced) and pre-existing resistance-associated variants with a fair tolerance and reduced pill burden. International guidelines recommend to ideally treat all infected patients even if a prioritization of the most severe patients (extensive fibrosis or cirrhosis, symptomatic cryoglobulinaemic vasculitis…) appears to be the best cost-effective and urgent policy. Patients with stage 4-5 chronic kidney disease (CKD) have to be considered as priority patients. Updating of the Kidney Disease: Improving Global Outcomes recommendations is due to start soon, but awaiting their availability, we present here an overview of recent developments in the field.
authors.affiliation: Université Paris Descartes, Paris, France.|Hepatology Department, Cochin Hospital, APHP, Paris, France.|INSERM UMS-20, Institut Pasteur, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Department of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Jadoul
authors.affiliation: Université Paris Descartes, Paris, France.|Hepatology Department, Cochin Hospital, APHP, Paris, France.|INSERM UMS-20, Institut Pasteur, Paris, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet-Pichard
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D019468:Disease Management; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000821:virology
chemical_list: D000998:Antiviral Agents