Journal Article

APASL clinical practice recommendation: how to treat HCV-infected patients with renal impairment?

Barjesh Chander Sharma, Moriyama, Mitsuhiko, Sollano, Jose, A Kadir Dokmeci, Jafri Wasim, Sarin, Shiv Kumar, Ming-Lung, Yu, Ibrahim, Alaaeldin, Lai, Wei, Wang-Long, Chuang, Yokosuka, Osamu, Cosmas Rinaldi Adithya Lesmana, Crawford, Darrell H G, Kumar, Manoj, Jindal, Ankur, McCaughan, Geofferey W, Jia-Horng Kao, Kanda, Tatsuo, Omata, Masao, Mamun-Al-Mahtab, Lau, George K K, Hamid, Saeed S

2019

Overview

Chronic hepatitis C virus (HCV) infection is common among patients with chronic kidney disease (CKD) and those on hemodialysis due to nosocomial infections and past blood transfusions. While a majority of HCV-infected patients with end-stage renal disease are asymptomatic, some may ultimately experience decompensated liver diseases and hepatocellular carcinoma. Administration of a combination of elbasvir/grazoprevir for 12 weeks leads to high sustained virologic response (SVR) rates in patients with HCV genotypes (GTs) 1a, 1b or 4 and stage 4 or 5 CKD. Furthermore, a combination of glecaprevir/pibrentasvir for 8–16 weeks also results in high SVR rates in patients with all HCV GTs and stage 4 or 5 CKD. However, these regimens are contraindicated in the presence of advanced decompensated cirrhosis. Although sofosbuvir and/or ribavirin are not generally recommended for HCV-infected patients with severe renal impairment, sofosbuvir-based regimens may be appropriate for those with mild renal impairment. To eliminate HCV worldwide, HCV-infected patients with renal impairment should be treated with interferon-free therapies.

• Publisher: Springer Nature B.V
• Subject: Blood transfusion / Chronic infection / Cirrhosis / Dialysis / End-stage renal disease / Genotypes / Hemodialysis / Hepatitis / Hepatitis C / Hepatocellular carcinoma / Hospitals / Impairment / Interferon / Kidney diseases / Liver / Liver cancer / Liver diseases / Nosocomial infection / Patients / Renal function / Ribavirin / Viruses