慢性肾脏病中丙型肝炎病毒管理的进展。
Progress in hepatitis C virus management in chronic kidney disease.
机构信息
Renal Division and Transplant Center, Massachusetts General Hospital, Harvard Medical School.
Renal Section, Department of Medicine, Boston University School of Medicine.
出版信息
Curr Opin Nephrol Hypertens. 2021 Sep 1;30(5):493-500. doi: 10.1097/MNH.0000000000000729.
PURPOSE OF REVIEW
The current review highlights advances in the use of direct-acting antiviral (DAA) agents in the treatment of hepatitis C virus (HCV) in chronic kidney disease (CKD) stages G4-5, end-stage renal disease, and kidney transplantation. The use of DAA to facilitate kidney transplantation of HCV negative recipients with kidneys from HCV-infected donors and in the management of HCV-related cryoglobulinemia are also reviewed.
RECENT FINDINGS
DAA treatment results in rates of viral clearance (sustained virological response or SVR) of 90-100% in all studied CKD populations, comparable to SVR rates in the general population. DAA treatment allows safe and effective transplantation of HCV viremic kidneys into uninfected recipients.
SUMMARY
The high SVR results achieved with DAA allow successful treatment of previously under-treated CKD populations, and encouraged innovative interventions such as the use of HCV-infected donor kidneys to uninfected kidney transplant recipients.
目的综述
本文重点介绍了直接作用抗病毒（DAA）药物在慢性肾脏病（CKD）G4-5 期、终末期肾病和肾移植患者中治疗丙型肝炎病毒（HCV）中的应用进展。本文还回顾了 DAA 在促进 HCV 阴性受者接受 HCV 感染供者肾脏移植和治疗 HCV 相关冷球蛋白血症中的应用。
最近的发现
在所有研究的 CKD 人群中，DAA 治疗可使病毒清除率（持续病毒学应答或 SVR）达到 90-100%，与普通人群中的 SVR 率相当。DAA 治疗可安全有效地将 HCV 病毒血症的供肾移植到未感染的受者体内。
总结
DAA 治疗可实现高 SVR 率，从而成功治疗以前治疗不足的 CKD 人群，并鼓励了一些创新干预措施，如使用 HCV 感染供者的肾脏移植给未感染的肾移植受者。
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