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
- Medical Director and Co-Director of the Comprehensive Transplant Center, Department of Internal Medicine, Division of Nephrology
- Johns Hopkins Medical School
- 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.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS