Saadi Gamal, Kalantar-Zadeh Kamyar, Almasio Piero, Ashuntantang Gloria, Barsoum Rashad, Bruchfeld Annette, Doss Wahid, ElFishawy Hussein, Raziky Maissa El, El-Serafy Magdy, Fabrizi Fabrizio, Hafez Hani, Hassaballa May, Hammady Mona M R, Sheishaa Hussein, Abdelaziz Tarek S, Ulasi Ifeoma, Zakharova Elena, Jadoul Michel
Department of Nephrology, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Irvine, California, USA.
Afr J Nephrol. 2020;23(1):159-168.
Hepatitis C virus (HCV) infection is an important cause of major morbidities including chronic liver disease, liver cancer, and acute kidney injury (AKI) as well as chronic kidney disease (CKD). HCV can affect kidney health; among CKD and AKI patients with HCV infection, the clinical outcomes are worse. The prevalence of HCV infection is exceptionally high among dialysis and kidney transplant patients throughout the globe. It is estimated that 5% to 25% or more of dialysis dependent patients are affected by chronic HCV, based on the region of the world. Almost half of all deaths in CKD patients, including HCV-infected patients, are due to cardiovascular disease, and HCV infected patients have higher mortality. Given the importance and impact of the HCV epidemic on CKD and global kidney health, and the status of Egypt as the nation with highest prevalence of HCV infection in the world along with its leading initiatives to eradicate HCV, the International Federation of Kidney Foundations (IFKF) convened a consensus conference in Cairo in December 2017. This article reflects the opinions and recommendations of the contributing experts and reiterates that with the current availability of highly effective and well tolerated pharmacotherapy; CKD patients should be given priority for treatment of HCV, as an important step towards the elimination of viral hepatitis as a public health problem by 2030 according to World Health Organization and IFKF. Every country should have an action plan with the goal to improve kidney health and CKD patient outcomes.
丙型肝炎病毒（HCV）感染是包括慢性肝病、肝癌、急性肾损伤（AKI）以及慢性肾脏病（CKD）在内的主要疾病的重要病因。HCV可影响肾脏健康；在感染HCV的CKD和AKI患者中，临床结局更差。全球范围内，透析患者和肾移植患者中HCV感染的患病率异常高。据估计，根据世界不同地区，5%至25%或更多的依赖透析的患者受到慢性HCV感染。在包括HCV感染患者在内的CKD患者中，几乎一半的死亡是由心血管疾病导致的，且HCV感染患者的死亡率更高。鉴于HCV流行对CKD和全球肾脏健康的重要性和影响，以及埃及作为世界上HCV感染患病率最高的国家及其根除HCV的主要举措，国际肾脏基金会联合会（IFKF）于2017年12月在开罗召开了一次共识会议。本文反映了与会专家的意见和建议，并重申鉴于目前有高效且耐受性良好的药物治疗方法；CKD患者应优先接受HCV治疗，这是根据世界卫生组织和IFKF到2030年将病毒性肝炎作为公共卫生问题消除的重要一步。每个国家都应有一个旨在改善肾脏健康和CKD患者结局的行动计划。
