肾移植候选者和受者的丙型肝炎病毒感染
- Authors
- 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
- Martin S Hirsch, MD
Martin S Hirsch, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Viral Infections
- Professor of Medicine
- Harvard 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
- Deputy Editors
- Albert Q Lam, MD
Albert Q Lam, MD
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
- Allyson Bloom, MD
Allyson Bloom, MD
- Senior Deputy Editor — UpToDate
- Deputy Editor — Infectious Diseases
- Clinical Instructor in Medicine
- Harvard Medical School
- Translators
- 林潮双, 主任医师
林潮双, 主任医师
- 中山大学附属第三医院感染性疾病科
引言
丙型肝炎病毒(hepatitis C virus, HCV)可引起自体肾和移植肾发生肾病。与无HCV感染的肾移植受者相比，HCV感染的肾移植受者在移植后的患者生存和移植肾存活都更差。
肾移植后早期发现、预防和治疗HCV相关肾病可提高这一人群的移植后结局[1]。
本专题将总结肾移植受者的HCV感染。透析患者、肾移植供者以及一般人群中的HCV感染将在别处讨论。 (参见“肾脏供者的丙型肝炎病毒感染”和“维持性透析患者中的丙型肝炎病毒感染”和“慢性丙型肝炎病毒感染的临床表现和自然病程”和“慢性丙型肝炎病毒感染的诊断与评估”和“慢性丙型肝炎病毒感染的处理概述”)
流行病学
据报道，肾移植受者中HCV感染的患病率大约为1.8%-8%[2-6]。大部分HCV感染的肾移植受者是在移植前在接受透析时感染的[5]。由于会对供者进行筛查，通过肾移植发生HCV传播的情况很少见[5]。 (参见“肾脏供者的丙型肝炎病毒感染”)
移植候选者的筛查
我们同意2008年改善全球肾脏病预后组织(Kidney Disease: Improving Global Outcomes, KDIGO)的指南，即所有移植候选者都应筛查有无HCV感染[7]。既往已成功治疗HCV感染的移植候选者应该至少每年重新筛查一次。
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-05-31.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. Kidney Int Suppl 2008; :S1.
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