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© Research
Publication : Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

An update on the management of hepatitis C virus-infected patients with stage 4-5 chronic kidney disease while awaiting the revised KDIGO Guidelines

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association - 22 Mar 2016

Pol S, Jadoul M, Vallet-Pichard A

Link to Pubmed [PMID] – 27005992

Nephrol. Dial. Transplant. 2016 Mar;

The treatment of hepatitis C virus (HCV) infection has progressed markedly over the last 2 decades, with a dramatic acceleration the last 3 years. The combination of two or three direct-acting antiviral drugs (DAAs) targeting viral proteins [NS3/4A protease inhibitors, NS5B nucleos(t)idic and non-nucleos(t)idic polymerase inhibitors, NS5A replication complex inhibitors], with or without ribavirin but without interferon (interferon-free regimen), for 8-24 weeks, achieved high sustained virological response (>90%), whatever fibrosis stage, genotype and subtype, baseline viral load, prior therapeutic history of the patient (naïve or experienced) and pre-existing resistance-associated variants with a fair tolerance and reduced pill burden. International guidelines recommend to ideally treat all infected patients even if a prioritization of the most severe patients (extensive fibrosis or cirrhosis, symptomatic cryoglobulinaemic vasculitis…) appears to be the best cost-effective and urgent policy. Patients with stage 4-5 chronic kidney disease (CKD) have to be considered as priority patients. Updating of the Kidney Disease: Improving Global Outcomes recommendations is due to start soon, but awaiting their availability, we present here an overview of recent developments in the field.

https://www.ncbi.nlm.nih.gov/pubmed/27005992