Ribavirin with interferon for hepatitis C in dialysis patients: efficacious and safe in the right patients in good hands

Hepatitis C virus infection, with both hepatic and extrahepatic manifestations, is an important issue for patients requiring renal replacement therapy (RRT) and for those who receive kidney transplants (KT). Registry studies show a clear adverse impact of HCV-positivity on RRT patient survival and on KT graft and patient survival.1 In pretransplant and post-transplant settings, HCV-positivity (vs uninfected patients) is clearly associated with a relatively increased liver-related mortality and morbidity. However, reflecting the frequent comorbid cardiovascular disease that is observed in these settings, the absolute risk for cardiovascular mortality is much greater than risk of HCV-related mortality in patients with RRT and KT. Remarkably, the risk for cardiovascular disease appears increased in HCV-positive versus HCV-negative patients. There are obvious merits in HCV clearance for selected patients on RRT. Successful treatment should prevent or substantially reduce the risk for liver-related problems including hepatic decompensation and primary liver cancer. These...
Source: Gut - Category: Gastroenterology Authors: Tags: Commentary Source Type: research