Hepatitis C virus infection in kidney transplantation-changing paradigms with novel agents.
Hepatitis C virus infection in kidney transplantation-changing paradigms with novel agents.
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DOI：
10.1111/hdi.12659
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Francis JM
中科院分区：
文献类型：
--
作者：
Reddy YNV;Nunes D;Chitalia V;Gordon CE;Francis JM
丙型肝炎病毒（HCV）是肾移植患者发病率和死亡率增加的常见原因。它与移植后肾小球肾炎、慢性同种异体移植肾病和移植后新发糖尿病（NODAT）有关。在过去，丙型肝炎病毒很难治疗，因为基于干扰素的治疗方法难以耐受，并伴有不良副作用，如排斥风险。随着口服直接抗病毒治疗的出现，HCV和移植的前景发生了变化。这些药物非常有效，耐受性好，副作用很小。目前大多数治疗方案对所有HCV基因型均有效，可实现90%以上的持续病毒应答率。这些新药物可能会改善移植物和患者的生存，同时从根本上消除使用先前基于干扰素的HCV治疗的急性排斥反应的风险。这些药物也可能导致HCV供体/受体移植器官分配的改善。本文旨在讨论HCV的流行病学，新型口服直接作用抗病毒药物（DAAs）和HCV相关移植领域的未来研究机会。
Hepatitis C virus (HCV) is a common cause of increased morbidity and mortality in kidney transplant patients. It is associated with posttransplant glomerulonephritis, chronic allograft nephropathy, and New Onset Diabetes after Transplant (NODAT). In the past, HCV was difficult to treat due to the presence of interferon alpha-based therapies that were difficult to tolerate and were associated with adverse side-effects, such as the risk of rejection. With the advent of oral directly acting antiviral therapies, the landscape for HCV and transplantation has changed. These agents are highly effective and well tolerated with minimal side-effects. Sustained viral response rates in excess of 90% are achieved with most current treatment regimens active against all HCV genotypes. These new agents may show an improvement in graft and patient survival while essentially eliminating the risk of acute rejection from the use of prior interferon-based HCV therapies. These agents may also result in an improvement in organ allocation for HCV donor/HCV recipient transplantation. This review is meant to discuss the epidemiology of HCV, the new oral direct-acting antiviral agents (DAAs) and future opportunities for research in the field of HCV related transplantation.
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