Department of Medicine, Division of Gastroenterology, Hamad Medical Corporation , Doha, Qatar.
Weill Cornell Medical College , New York, Qatar.
Expert Rev Gastroenterol Hepatol. 2020 Jul;14(7):579-590. doi: 10.1080/17474124.2020.1776111. Epub 2020 Jul 2.
Hepatitis C virus (HCV) infection is associated with an increased incidence and progression of chronic kidney disease (CKD), as well as higher mortality in CKD and renal transplant patients. Direct acting antiviral agents (DAAs) have revolutionized the treatment of HCV, with viral eradication attained in 90-100% of treated patients. DAAs have an excellent safety and tolerability profile in CKD and renal transplant patients.
In this review, we discuss the association of HCV with incidence and progression of CKD as well as its effect on outcomes and mortality. We also discuss the available treatment options in patients with CKD and renal transplant and in HCV-associated glomerular disease.
The availability of newly available direct acting anti-viral agents has revolutionized the treatment of HCV in persons with advanced CKD and undergoing dialysis. With these regimens, viral eradication can be attained in 90-100% of the treated patients. The safety, tolerability, and efficacy of these drugs in renal transplant patients have also made it possible to use HCV-infected grafts and successful virus eradication at a later stage.
丙型肝炎病毒 (HCV) 感染与慢性肾脏病 (CKD) 的发病率和进展增加有关，并且在 CKD 和肾移植患者中死亡率更高。直接作用抗病毒药物 (DAA) 彻底改变了 HCV 的治疗方法，接受治疗的患者中 90-100% 实现了病毒清除。DAA 在 CKD 和肾移植患者中具有极好的安全性和耐受性。
在这篇综述中，我们讨论了 HCV 与 CKD 的发病率和进展以及对结局和死亡率的影响之间的关联。我们还讨论了 CKD 和肾移植患者以及与 HCV 相关的肾小球疾病患者的可用治疗选择。
新型直接作用抗病毒药物的出现彻底改变了晚期 CKD 患者和接受透析治疗患者的 HCV 治疗方法。通过这些方案，90-100%的接受治疗的患者可以实现病毒清除。这些药物在肾移植患者中的安全性、耐受性和疗效也使得使用 HCV 感染的移植物和以后成功清除病毒成为可能。
