Treatment of HCV infected patients and renal disease

Abstract

Hepatitis C signifies a highly prevalent infection in patients with end stage renal disease. Most frequently it is associated to glomerulonephritis, patients on hemodyalisis and renal transplants. The prevalence of HCV antibodies in hemodialysis patients varies between 5-70% depending on the geographical location of the patients. Factors associated with the prevalence of anti HCV in patients with hemodialysis include: age, blood transfusions, tattoos, use of illegal drugs, time in hemodialysis, more than two hospitalizations, treatment in multiple hemodialysis units or a kidney transplant. In some of the reported outbreaks of hepatitis in hemodialysis units, the phylogenetic analysis indicate that the transmission of HCV could relate to failures or breaches in general precautions in the management of these type of patients resulting in nosocomial transmission owed to sharing equipment or instruments employed in the hemodialysis or by transmission from professional members of the hemodialysis units. Antiviral treatment may be affected by a number of co-factors and co-morbidities, it consist mainly of non pegylated interferon or pegylated inter-feron. The treatment with interferon after a renal transplant is associated with an increase in the number of rejections; reason enough to recommended that treatment should be administered before the transplant.