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World J Hepatol. Apr 28, 2015; 7(6): 885-895
Published online Apr 28, 2015. doi: 10.4254/wjh.v7.i6.885
Hepatitis C infection in hemodialysis patients: A review
Digdem Ozer Etik, Serkan Ocal, Ahmet Sedat Boyacioglu
Digdem Ozer Etik, Serkan Ocal, Ahmet Sedat Boyacioglu, Department of Gastroenterology, Baskent University, 06000 Ankara, Turkey
Author contributions: All the authors equally contributed to this work.
Conflict-of-interest: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmet Sedat Boyacioglu, MD, FRCP, FEBGH, Professor, Department of Gastroenterology, Baskent University, Bağlıca Kampüsü Eskişehir Yolu 20. km, 06000 Ankara, Turkey. dr.sedat.boyacioglu@gmail.com
Telephone: +90-532-5213181 Fax: +90-312-2152962
Received: August 15, 2014
Peer-review started: August 15, 2014
First decision: November 27, 2014
Revised: January 3, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: April 28, 2015
Processing time: 260 Days and 15.9 Hours
Abstract

Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications post-transplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.

Keywords: Hepatitis C virus; Hemodialysis; End-stage renal disease; Kidney transplantation; Hepatitis C treatment

Core tip: Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease who are treated with dialysis or KT. Early diagnosis and treatment of HCV infection prior kidney transplantation (KT) prevent complications after transplantation and reduces mortality. Issues with current mode HCV therapy include lack of tolerability and suboptimal response rates.