Management of dialysis patients with hepatitis C virus in the era of direct‐acting antiviral therapy

Abstract

The clinical use of direct‐acting antivirals (DAAs) for hepatitis C virus (HCV) infection has dramatically changed management of patients with HCV liver disease since 2014; this is also true for patients undergoing dialysis. Due to the high tolerability and antiviral efficacy of anti‐HCV therapy, most dialysis patients with HCV infection should currently be candidates for this treatment. Many patients with HCV antibodies no longer have HCV infection, and it is difficult to identify patients with actual HCV infection based only on HCV antibody assays. Despite the high rate of successful HCV eradication, the risk of liver‐related events such as hepatocellular carcinoma (HCC), the major complication of HCV infection, persists even after HCV cure, and patients at risk of HCC should undergo continuous HCC surveillance. Finally, the rarity of HCV reinfection and the survival benefit of HCV eradication in dialysis patients should be explored in further studies.

Authors response to Management of dialysis patients with hepatitis C virus in the era of direct‐acting antiviral therapy

“…We greatly appreciate the comment by Profs. Jadoul and Labriola [1] on our review of dialysis patients with hepatitis C virus (HCV) infection [2]. The clinical use of anti-HCV therapy with direct-acting antivirals (DAAs) has made it common worldwide to achieve sustained virologic response (SVR), meaning that HCV has been eradicated in patients with HCV infection.…”

Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis

“…Direct-acting antiviral agents (DAAs) have emerged as highly effective treatments for chronic hepatitis C (CHC)[ 3 , 4 ]. Numerous studies have highlighted the exceptional tolerability of these drugs, even among the most vulnerable patients, including those undergoing dialysis[ 5 ], awaiting liver transplantation[ 6 ], or affected by cardiac pathologies[ 7 ]. This tolerability has led to a significant increase in the number of treated patients achieving a sustained virologic response (SVR), which exceeds 90%[ 8 ] and represents a crucial benchmark for success in hepatitis C treatment.…”

Sofosbuvir and Velpatasvir Regimen Outcome for Chronic Hepatitis C Patients With End-Stage Renal Disease Undergoing Hemodialysis

“…Oral interferon‐free direct-acting antivirals (DAAs) have become the first-line standard-of-care treatment of HCV that help reduce inflammation in the liver, slow or stop fibrosis progression, and lower the risks of hepatocellular carcinoma [ 5 ]. Among these, pan-genotypic DAAs are widely considered for HCV-infected patients to obtain a sustained virologic response (SVR) due to their tolerability, effectiveness, and affordability [ 6 ].…”