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Nephrol Dial Transplant (2004) 19: 1049-1053
Nephrol Dial Transplant Vol. 19 No. 5 © ERA-EDTA 2004; all rights reserved

Editorial Comment

Chronic hepatitis virus infections in patients on renal replacement therapy

Thomas Fehr and Patrice M. Ambühl

Division of Nephrology, Department of Internal Medicine, University Hospital, Zurich, Switzerland

Correspondence and offprint requests to: Thomas Fehr, MD, Transplantation Biology Research Center, Massachusetts General Hospital, MGH East CNY 149, 13th street, Boston, MA 02129, USA. Email: thomas.fehr@tbrc.mgh.harvard.edu

Keywords: diagnosis; dialysis; hepatitis; therapy; transplantation

The first 150 words of the full text of this article appear below.



   The magnitude of the problem
 
Hepatitis B (HBV) and C (HCV) virus infections represent a major problem in dialysis patients and renal allograft recipients.

  1. They cause renal failure due to glomerulonephritis, which may recur in the renal transplant [1].
  2. Patients with chronic renal failure have acquired hepatitis virus infection via blood transfusions, which were necessary to treat hyporegenerative renal anaemia. With the advent of recombinant human erythropoietin, this has now become a minor source of transmission. However, repetitive invasive diagnostic and therapeutic interventions still cause major bleeding episodes in the context of uraemia.
  3. HBV and HCV infections are difficult to treat because of the limited efficacy and a high rate of side effects of the available drugs.
  4. No HCV vaccination is available yet.



   Prevalence of HBV and HCV infection
 
The prevalence of HBV and HCV infection in patients on renal replacement therapy varies considerably among different areas of the world (Table 1) [2]. It is . . . [Full Text of this Article]



   Diagnostic approach
 


   Diagnosis of infection
 
HBV infection
HCV infection


   Assessment of liver disease severity
 


   Therapeutic approach
 


   Role and risks of interferon therapy
 


   Specific therapeutic options in different patient groups
 
HBV infection
HCV infection


   Conclusion
 

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