Hepatitis C Infection Is Very Rarely Treated among Hemodialysis Patients.

Goodkin, David A;Bieber, Brian;Gillespie, Brenda;Robinson, Bruce M;Jadoul, Michel
(2013) American Journal of Nephrology — Vol. 38, n° 5, p. 405-412 (2013)

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Authors
  • Goodkin, David A
    Author
  • Bieber, Brian
    Author
  • Gillespie, Brenda
    Author
  • Robinson, Bruce M
    Author
  • Jadoul, MichelUCLouvain
    Author
Abstract
Background: Hepatitis C virus (HCV) infection is associated with increased mortality among hemodialysis (HD) patients. Guidelines from Kidney Disease: Improving Global Outcomes recommend that infected HD patients awaiting renal transplantation be treated for HCV and that clinicians decide whether to treat other infected patients on a case-by-case basis. We evaluated the extent and outcome of HCV therapy among HD patients. Methods: The Dialysis Outcomes and Practice Patterns Study is an observational study; 49,762 HD patients in 12 nations enrolled between 1996 and 2011. We reviewed HCV status, use of interferon or ribavirin, and survival over a median 1.4 years per study phase. Results: 4,735 patients (9.5%) were HCV+. Only 48 (1.0%) of the 4,589 HCV+ patients with prescription data were receiving antiviral medication. Among the subset of 617 HCV+ patients also known to be on a waiting list for renal transplantation, only 3.7% were receiving treatment. After restricting to HCV+ patients with overlapping propensity for antiviral treatment, 4 (9.5%) of 42 treated patients and 638 (21.0%) of 3,037 untreated patients died. The hazard ratio for adjusted mortality comparing treated patients with untreated patients was 0.47 (95% CI, 0.17-1.26). Conclusions: HD patients with hepatitis C infection very rarely receive antiviral therapy. Increased intervention might prolong survival for some patients and in particular might improve the prospects for those awaiting renal transplantation. © 2013 S. Karger AG, Basel.
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Goodkin, D. A., Bieber, B., Gillespie, B., Robinson, B. M., & Jadoul, M. (2013). Hepatitis C Infection Is Very Rarely Treated among Hemodialysis Patients. American Journal of Nephrology, 38(5), 405-412. https://doi.org/10.1159/000355615 (Original work published 2013)