Management of Hepatitis C Virus and Hepatitis B Virus Infection in the Setting of Kidney Disease

Overview

Journal Adv Kidney Dis Health

Specialty Nephrology

Date 2023 Sep 1

PMID 37657881

Authors

Purva Sharma

Rani Sawtell

Qiyu Wang

Meghan E Sise

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

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Current perspectives of viral hepatitis.

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Post-Transplant Glomerulonephritis: Challenges and Solutions.

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