Chronic hcv-infection among patients receiving renal replacement therapy
Abstract
Despite a significant decrease in the prevalence of chronic HCV-infection among patients receiving renal replacement therapy, it is still a challenge, primarily for patients in a waiting list and after kidney transplantation, because HCV-infection adversely affects both recipient survival, and the duration of the graft functioning. The use of antiviral therapy with interferon has limited effect due to a significant number of serious adverse events in the dialysis population. Besides, it was shown to be dangerous for kidney transplant recipients because of the high risk of irreversible rejection. Prescription of ribavirin, on the contrary, was considered inappropriate for patients on hemodialysis, because of the possibility of worsening of renal anemia. The introduction of modern direct antiviral drugs into clinical practice has radically improved the efficacy and safety of the treatment of chronic HCV-infection. However, the use of these drugs in patients with severe renal dysfunction is quite specific primarily due to the possibility of adverse drug-drug interaction with immunosuppressors in kidney transplant recipients. In this review, we consider the development of chronic HCV-infection and the prognosis in patients on renal replacement therapy, as well as the opportunities, conditions and tactics for the new antiviral therapies in this patient population.
About the Authors
M. L. Zubkin
G.N. Gabrichevsky Research Institute for epidemiology and microbiology; The branch of the S.M.Kirov Military Medical Academy
Russian Federation
Russian Federation
V. I. Chervinko
The branch of the S.M.Kirov Military Medical Academy
Russian Federation
Russian Federation
E. V. Kryukov
N.N. Burdenko Main Military Clinical Hospital
Russian Federation
Russian Federation
N. F. Frolova
Moscow City Clinical Hospital № 52, Healthcare Department of Moscow
Russian Federation
Russian Federation
A. I. Ushakova
Moscow City Clinical Hospital № 52, Healthcare Department of Moscow
Russian Federation
Russian Federation
O. V. Logunov
G.N. Gabrichevsky Research Institute for epidemiology and microbiology
Russian Federation
Russian Federation
O. N. Kotenko
Moscow City Clinical Hospital № 52, Healthcare Department of Moscow
Russian Federation
Russian Federation
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Zubkin M.L., Chervinko V.I., Kryukov E.V., Frolova N.F., Ushakova A.I., Logunov O.V., Kotenko O.N. Chronic hcv-infection among patients receiving renal replacement therapy. Nephrology and Dialysis. 2016;18(4):374-386. (In Russ.)
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