Treatment of Hepatitis C Virus Infection in Patients with End-stage Renal Disease

Chen-Hua Liu; Jia-Horng Kao

Disclosures

J Gastroenterol Hepatol. 2011;26(2):228-239. 

In This Article

Natural History of HCV Infection in ESRD Patients

The natural history of chronic HCV infection in ESRD patients remained unclear during the early years of HCV infection. This is because the morbidity and mortality rates in ESRD patients were generally higher than those in the general population, making the long-term consequences of HCV infection difficult to clarify. However, recent studies have clearly shown that HCV-infected ESRD patients on maintenance dialysis are at increased risk of liver-related mortality.[13,26,42–51] In addition, HCV infection adversely decreases the heath-related quality of life in these patients.[52] Although ESRD patients with chronic hepatitis C receiving renal transplantation (RT) usually have a higher survival rate than those on maintenance dialysis, several studies indicate that these patients have a poorer patient and graft survival after RT.[53–60] However, HCV-infected patients have accelerated hepatic fibrosis and deterioration of hepatic necroinflammation after RT, suggesting that immunosuppression following RT could worsen the course of liver disease.[61–64]

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