Management of hepatitis C virus infection in patients with chronic kidney disease: position statement of the joint committee of Italian association for the study of the liver (AISF), Italian society of internal medicine (SIMI), Italian society of infectious and tropical disease (SIMIT) and Italian society of nephrology (SIN)

Abstract

Hepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal patients. In the last few years, availability of more specific and effective drugs against HCV has dramatically changed the clinical course of this disease. These drugs may provide further advantages in the CKD population as a whole by reducing progression of renal disease, mortality rate and by increasing the survival of graft in renal transplant recipients. The strict pathogenetic and prognostic link between HCV infection and CKD requires an ongoing relationship among the healthcare professionals involved in the treatment of both HCV infection and CKD. Therefore, Scientific Societies involved in the care of this high-risk population in Italy have organized a joint expert panel. The aim of the panel is to produce a position statement that can be used in daily clinical practice for the management of HCV infected patients across the whole spectrum of renal disease, from the conservative phase to renal replacement treatments (dialysis and transplantation). Sharing specific evidence-based expertise of different professional healthcare is the first step to obtain a common ground of knowledge on which to instate a model for multidisciplinary management of this high-risk population. Statements cover seven areas including epidemiology of CKD, HCV-induced glomerular damage, HCV-related renal risk, staging of liver disease in patients with CKD, prevention of transmission of HCV in hemodialysis units, treatment of HCV infection and management of HCV in kidney transplantation.

The Impact of Vascular Access Types on Hemodialysis Patient Long-term Survival

“…The patients’ baseline characteristics were collected from their first visit for hemodialysis and biochemical parameters were extracted from their routine quarter tests, which were performed by an automatic and standardized College of American Pathologists (CAP) approved central laboratory and recorded by hospital electronic system 26 . The prevalence of anti-HCV positivity was significantly higher in late stage of CKD/dialysis patients when compared with general population 27–29 . Ravel et al .…”

Real‐life efficacy and safety of glecaprevir/pibrentasvir in HCV‐infected patients with chronic kidney disease

“…13,15 Given the high efficacy of an 8-week G/P regimen in non-cir- Panel supports this therapeutic approach in non-cirrhotic patients with CKD and/or ESRD. 19 Notably, despite the different prevalence of liver cirrhosis between patients with and without ESRD, the prevalence of SVR did not differ between the two groups. Consequently, The safety of G/P was excellent in our patients.…”

Position paper on liver and kidney diseases from the Italian Association for the Study of Liver (AISF), in collaboration with the Italian Society of Nephrology (SIN)

“…The need for in-center hemodialysis during the course of the disease will put these patients at risk of acquiring HCV infection comparable to other dialyzed patients. Therefore, since these patients transiently receive in-center hemodialysis, they should undergo HCV infection screening upon initiation of home or peritoneal dialysis to document baseline HCV infection status, and the case for interim in-center hemodialysis [3] .…”