Hepatitis C infection in kidney transplant candidates and recipients
- Marion Muche, MD
Marion Muche, MD
- Charité - Medical University, Berlin, Germany
- Seema Baid-Agrawal, MD
Seema Baid-Agrawal, MD
- Associate Professor of Medicine
- Sahlgrenska Medical University, Gothenburg, Sweden
- Section Editors
- Daniel C Brennan, MD, FACP
Daniel C Brennan, MD, FACP
- Editor-in-Chief — Nephrology
- Section Editor — Renal Transplantation
- Professor of Medicine
- Washington University School of Medicine
- Adrian M Di Bisceglie, MD
Adrian M Di Bisceglie, MD
- Section Editor — Hepatitis C
- Chief of Hepatology
- Saint Louis University School of Medicine
Hepatitis C virus (HCV) causes renal disease in native and transplanted kidneys. HCV-infected renal transplant recipients have worse patient and allograft survival after transplantation compared with noninfected renal transplant recipients.
Early detection, prevention, and treatment of HCV-related renal disease after kidney transplantation could improve posttransplant outcomes in this population .
This topic reviews HCV infection in the renal transplant recipient. HCV infection among dialysis patients, in the renal transplant donor, and in the general population is discussed elsewhere. (See "Hepatitis C virus infection in kidney donors" and "Hepatitis C virus infection in patients on maintenance dialysis" and "Clinical manifestations and natural history of chronic hepatitis C virus infection" and "Diagnosis and evaluation of chronic hepatitis C virus infection" and "Overview of the management of chronic hepatitis C virus infection".)
The reported prevalence of HCV infection among renal transplant recipients is approximately 1.8 to 8 percent [2-6]. Most HCV-infected transplant recipients are infected prior to transplant, while on dialysis . The transmission of HCV through kidney transplantation is rare due to screening of donors . (See "Hepatitis C virus infection in kidney donors".)
HCV EVALUATION OF TRANSPLANT CANDIDATES
Screening for HCV infection — We agree with the 2008 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines that all transplant candidates should be screened for HCV infection . Transplant candidates who were previously successfully treated for HCV infection should be rescreened at least annually.
Subscribers log in hereLiterature review current through: May 2017. | This topic last updated: May 31, 2017.References
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- HCV EVALUATION OF TRANSPLANT CANDIDATES
- Screening for HCV infection
- Liver biopsy for HCV-infected patients
- Pre-HCV treatment evaluation
- COMPLICATIONS AFTER TRANSPLANTATION
- Liver disease
- Renal disease
- New-onset diabetes after transplantation
- Posttransplant lymphoproliferative disorder
- MONITORING AFTER TRANSPLANTATION
- ANTIVIRAL TREATMENT
- Timing of treatment
- Regimen selection before transplantation
- Regimen selection after transplantation
- - eGFR >30 mL/min/1.73 m2
- - eGFR <30 mL/min/1.73 m2
- - Interactions with immunosuppressive agents
- TREATMENT WITH ANTIPROTEINURIC AGENTS
- Compared with HCV-negative transplant recipients
- Compared with dialysis
- Effect of HCV genotype on survival after renal transplantation
- SUMMARY AND RECOMMENDATIONS