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Hepatitis C in Dialysis Patients, pp. 111-134 $100.00
Authors:  (Magid A. Fahim, David W. Johnson, Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia)
Abstract:
Hepatitis C virus (HCV) infection affects more than 170 million people worldwide and is recognised as both a cause and consequence of end-stage kidney failure. The incidence rates of HCV infection are considerably higher in dialysis patients than in the general population and are 3-fold higher in haemodialysis patients than peritoneal dialysis patients. Risk factors for HCV infection in dialysis patients include blood transfusion number, haemodialysis duration, dialysis unit HCV prevalence, prior kidney transplantation, intravenous drug use, male gender and older age. Improved infection control practices for HCV-infected patients, such as staff barrier protection, environmental hygiene precautions, medication / equipment and waste handling procedures, and avoidance of blood transfusions have been associated with an appreciable reduction in HCV occurrence in dialysis units in the past decade, although prevalence rates as high as 17% continue to be reported in some Asia-Pacific countries. HCV infection in the setting of dialysis poses significant diagnostic and management problems because of impaired diagnostic value of some tests, higher risks of drug toxicities from antiviral therapies (especially ribavirin), and a general lack of clinical trials in this patient population. Consequently, the presence of HCV in dialysis patients correlates with substantially increased morbidity and mortality. The aim of this article is to review the epidemiology of HCV in dialysis and to discuss strategies for screening, transmission prevention, treatment and evaluation/management prior to kidney transplantation. 


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Hepatitis C in Dialysis Patients, pp. 111-134