摘要
Hepatitis C virus （HCV）-related liver disease is asignificant cause of morbidity and mortality in patientswith end-stage renal disease （ESRD） who is treated withdialysis or kidney transplantation （KT）. The survival ratefor HCV-infected renal transplant recipients is betterthan that for HCV-infected hemodialysis patients ontransplant waiting lists. Early diagnosis and treatmentHCV infection prior to KT prevents complications posttransplantationand reduces mortality. In addition toscreening for anti-HCV antibodies and detecting HCVRNA, percutaneous liver biopsy is particularly valuablefor assessing the stage of liver damage in HCV-infectedpatients, because the stage of fibrosis is important
Hepatitis C virus(HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease(ESRD) who is treated with dialysis or kidney transplantation(KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications posttransplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is importantdetermining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon(IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses(SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.
