Details

Autor(en) / Beteiligte

• Mathur, Poonam
• Kottilil, Shyamasundaran
• Husson, Jennifer

Titel

Treatment of hepatitis C in renal impairment and renal transplant

Ist Teil von

• Current treatment options in infectious disease, 2016, Vol.8 (4), p.438-448

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2016

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Opinion statement Chronic hepatitis C infection is a major cause of morbidity and mortality in the USA. Treatment options have progressed from interferon-based regimens with moderate efficacy and many adverse effects to the use of directly-acting antiviral agents that are highly efficacious with limited side effect profiles. There is a disproportionate number of patients with end-stage renal disease who are infected with hepatitis C and have an increased risk of cirrhosis and hepatocellular carcinoma, while suffering from a lower quality of life. Renal transplant patients with hepatitis C additionally have an increased risk of graft failure, so treatment is of utmost importance in this population. There are currently several options for hepatitis C treatment in the renal impairment and transplant populations which have similar efficacy compared to the general population; however, the safety of these regimens is still being ascertained. Paritaprevir/ritonavir/ombitasvir and dasabuvir or elbasvir/grazoprevir are good options for use in patients with severe renal impairment or post-renal transplant; however, close monitoring is important given the potential for drug-drug interactions and the need for ribavirin in some of these patients. Several limited recent studies suggest that the efficacy and safety of full doses of sofosbuvir in these populations is not significantly different compared to that in the general population, though the safety of this dosing has not yet been established. Treatment of chronic hepatitis C infection in patients with renal impairment and/or transplant can significantly reduce the morbidity and mortality from cirrhosis and hepatocellular carcinoma, while serving as an effective public health tool to reduce transmission.