|Title:||APASL clinical practice recommendation: how to treat HCV-infected patients with renal impairment?||Authors:||Kanda T.
Mamun-Al-Mahtab, McCaughan G.W.
|Keywords:||DAA; Guideline; HCV; Hemodialysis; Renal impairment; SVR||Issue Date:||2019||Publisher:||Springer||Journal Volume:||13||Journal Issue:||2||Start page/Pages:||103-109||Source:||Hepatology International||Abstract:||
Chronic hepatitis C virus (HCV) infection is common among patients with chronic kidney disease (CKD) and those on hemodialysis due to nosocomial infections and past blood transfusions. While a majority of HCV-infected patients with end-stage renal disease are asymptomatic, some may ultimately experience decompensated liver diseases and hepatocellular carcinoma. Administration of a combination of elbasvir/grazoprevir for 12?weeks leads to high sustained virologic response (SVR) rates in patients with HCV genotypes (GTs) 1a, 1b or 4 and stage 4 or 5 CKD. Furthermore, a combination of glecaprevir/pibrentasvir for 8–16?weeks also results in high SVR rates in patients with all HCV GTs and stage 4 or 5 CKD. However, these regimens are contraindicated in the presence of advanced decompensated cirrhosis. Although sofosbuvir and/or ribavirin are not generally recommended for HCV-infected patients with severe renal impairment, sofosbuvir-based regimens may be appropriate for those with mild renal impairment. To eliminate HCV worldwide, HCV-infected patients with renal impairment should be treated with interferon-free therapies. ? 2018, The Author(s).
|ISSN:||1936-0533||DOI:||10.1007/s12072-018-9915-5||SDG/Keyword:||asunaprevir; beclabuvir; boceprevir; daclatasvir; elbasvir; elbasvir plus grazoprevir; glecaprevir; glecaprevir plus pibrentasvir; grazoprevir; ledipasvir; ledipasvir plus sofosbuvir; ombitasvir; ombitasvir plus paritaprevir plus ritonavir; paritaprevir; pibrentasvir; ribavirin; simeprevir; sofosbuvir; telaprevir; velpatasvir; voxilaprevir; ABT-493; antivirus agent; benzimidazole derivative; benzofuran derivative; elbasvir-grazoprevir drug combination; imidazole derivative; pibrentasvir; quinoxaline derivative; sofosbuvir; sulfonamide; Article; clinical practice; disease classification; drug efficacy; drug safety; hemodialysis; hepatitis C; human; kidney failure; kidney graft; priority journal; sustained virologic response; chronic hepatitis C; chronic kidney failure; complication; drug combination; drug contraindication; genetics; genotype; Hepacivirus; practice guideline; Antiviral Agents; Benzimidazoles; Benzofurans; Contraindications, Drug; Drug Combinations; Genotype; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; Kidney Failure, Chronic; Quinoxalines; Sofosbuvir; Sulfonamides; Sustained Virologic Response
|Appears in Collections:||臨床醫學研究所|
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