Management of Hepatitis C Virus and Hepatitis B Virus Infection in the Setting of Kidney Disease.
Adv Kidney Dis Health
; 30(4): 343-355, 2023 07.
Article
en En
| MEDLINE
| ID: mdl-37657881
Treatment of chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infection poses unique challenges in patients with kidney disease. Direct-acting antivirals have been a major breakthrough in eradicating HCV infection, and several pangenotypic regimens are available for patients with chronic kidney disease or end-stage kidney disease requiring dialysis with high cure rates and no need for dose adjustment. Direct-acting antiviral therapy alone can treat HCV-associated cryoglobulinemic glomerulonephritis; concurrent antiviral and immunosuppressive therapy is needed for cases of severe, organ-threatening manifestations of cryoglobulinemia. Immunosuppression may be needed for HBV-associated kidney disease (polyarteritis nodosa or membranous nephropathy) when there is evidence of severe immune-mediated injury while weighing the risk of potential viral activation. Most HBV antiviral agents need to be dose-adjusted in patients with chronic kidney disease or end-stage kidney disease requiring dialysis, and drug-drug interactions need to be carefully evaluated in patients with kidney transplants. Considerations for accepting HCV- and HBV-infected donors for kidney transplantation are discussed.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Hepatitis C
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Hepatitis C Crónica
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Insuficiencia Renal Crónica
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Hepatitis B
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Fallo Renal Crónico
Límite:
Humans
Idioma:
En
Revista:
Adv Kidney Dis Health
Año:
2023
Tipo del documento:
Article