A New Clinical Paradigm for Hepatitis C End-Stage Renal Disease Patients: Balancing Viral Eradication and Early Kidney Transplantation

Sanjay Kulkarni, Albert Do, AnnMarie Liapakis

Abstract


The development of safe and effective direct-acting antiviral (DAA) therapies for chronic hepatitis C virus (HCV) infection and more recent expansion of the therapy options with safety and efficacy in patients with severe chronic kidney disease (CKD), has changed the clinical paradigm for this subgroup of patients. The changing landscape and decision-making is particularly striking when balancing early kidney transplant with an HCV positive kidney allograft versus viral eradication. DAA therapy has allowed for revision of transplantation policy to expand acceptance criteria of HCV viremic severe CKD patients for kidney transplant alone, and also to consider utilization of grafts from HCV viremic donors. A variety of factors need to be considered in the care of these patients, including, accurate staging of liver disease, medication choice, timing of therapy in relation to kidney transplantation, and medication interactions. This clinical review provides an algorithm for the evaluation, triage, and treatment, of this population from the perspective of the hepatology and nephrology medical and transplant surgical subspecialties.

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References


FDA Advisory Committee Unanimously Recommends Approval of Telaprevir for People with Hepatitis C [press release]. 2011.

Jacobson IM. The HCV Treatment Revolution Continues: Resistance Considerations, Pangenotypic Efficacy, and Advances in Challenging Populations. Gastroenterol Hepatol (N Y). 2016;12(10 Suppl 4):1-11.

AASLD-IDSA. Recommendations for testing, managing, and treating hepatitis C. 2017 [Available from: http://www.hcvguidelines.org/.

4. European Association for the Study of the Liver. Electronic address eee. EASL Recommendations on Treatment of Hepatitis C 2016. J Hepatol. 2017;66(1):153-94.

Reau N. Pangenotypic Regimens and the Next Generation of HCV Treatment 2016 [updated Nov 14, 2016. Available from: http://liverlearning.aasld.org/.

Kidney Disease: Improving Global O. KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. Kidney Int Suppl. 2008(109):S1-99.

Lai TS, Lee MH, Yang HI, You SL, Lu SN, Wang LY, et al. Hepatitis C Viral Load, Genotype, and Increased Risk of Developing End-stage Renal Disease: REVEAL-HCV Study. Hepatology. 2017.

Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: how safe is it? Ann Intern Med. 1993;118(2):150-3.

Janes CH, Lindor KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med. 1993;118(2):96-8.

Manning DS, Afdhal NH. Diagnosis and quantitation of fibrosis. Gastroenterology. 2008;134(6):1670-81.

Talwalkar JA, Kurtz DM, Schoenleber SJ, West CP, Montori VM. Ultrasound-based transient elastography for the detection of hepatic fibrosis: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2007;5(10):1214-20.

Castera L. Noninvasive methods to assess liver disease in patients with hepatitis B or C. Gastroenterology. 2012;142(6):1293-302 e4.

Patel K, Gordon SC, Jacobson I, Hezode C, Oh E, Smith KM, et al. Evaluation of a panel of non-invasive serum markers to differentiate mild from moderate-to-advanced liver fibrosis in chronic hepatitis C patients. J Hepatol. 2004;41(6):935-42.

Imbert-Bismut F, Ratziu V, Pieroni L, Charlotte F, Benhamou Y, Poynard T, et al. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet. 2001;357(9262):1069-75.

Chou R, Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann Intern Med. 2013;158(11):807-20.

Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006;43(6):1317-25.

Crespo G, Fernandez-Varo G, Marino Z, Casals G, Miquel R, Martinez SM, et al. ARFI, FibroScan, ELF, and their combinations in the assessment of liver fibrosis: a prospective study. J Hepatol. 2012;57(2):281-7.

Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol. 2015;13(3):440-51 e6.

McHutchison JG, Lawitz EJ, Shiffman ML, Muir AJ, Galler GW, McCone J, et al. Peginterferon alfa-2b or alfa-2a with ribavirin for treatment of hepatitis C infection. N Engl J Med. 2009;361(6):580-93.

Kulkarni S, Taddei TH. When should a hepatitis C-positive ESRD patient receive a renal transplant? Semin Dial. 2011;24(4):438-9.

Munoz De Bustillo E, Ibarrola C, Colina F, Castellano G, Fuertes A, Andres A, et al. Fibrosing cholestatic hepatitis in hepatitis C virus-infected renal transplant recipients. J Am Soc Nephrol. 1998;9(6):1109-13.

Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G. Hepatitis C virus antibody status and survival after renal transplantation: meta-analysis of observational studies. Am J Transplant. 2005;5(6):1452-61.

Pereira BJ, Natov SN, Bouthot BA, Murthy BV, Ruthazer R, Schmid CH, et al. Effects of hepatitis C infection and renal transplantation on survival in end-stage renal disease. The New England Organ Bank Hepatitis C Study Group. Kidney Int. 1998;53(5):1374-81.

Knoll GA, Tankersley MR, Lee JY, Julian BA, Curtis JJ. The impact of renal transplantation on survival in hepatitis C-positive end-stage renal disease patients. Am J Kidney Dis. 1997;29(4):608-14.

Bloom RD, Sayer G, Fa K, Constantinescu S, Abt P, Reddy KR. Outcome of hepatitis C virus-infected kidney transplant candidates who remain on the waiting list. Am J Transplant. 2005;5(1):139-44.

Kamar N, Rostaing L, Selves J, Sandres-Saune K, Alric L, Durand D, et al. Natural history of hepatitis C virus-related liver fibrosis after renal transplantation. Am J Transplant. 2005;5(7):1704-12.

Alric L, Di-Martino V, Selves J, Cacoub P, Charlotte F, Reynaud D, et al. Long-term impact of renal transplantation on liver fibrosis during hepatitis C virus infection. Gastroenterology. 2002;123(5):1494-9.

Roth D, Gaynor JJ, Reddy KR, Ciancio G, Sageshima J, Kupin W, et al. Effect of kidney transplantation on outcomes among patients with hepatitis C. J Am Soc Nephrol. 2011;22(6):1152-60.

Pockros PJ, Reddy KR, Mantry PS, Cohen E, Bennett M, Sulkowski MS, et al. Efficacy of Direct-Acting Antiviral Combination for Patients With Hepatitis C Virus Genotype 1 Infection and Severe Renal Impairment or End-Stage Renal Disease. Gastroenterology. 2016;150(7):1590-8.

Gane E. RUBY-II: Efficacy and Safety of a Ribavirin-free Ombitasvir/ Paritaprevir/Ritonavir ± Dasabuvir Regimen in Patients with Severe Renal Impairment or End-Stage Renal Disease and HCV Genotypes 1a or 4 Infection 2016 [updated Nov 12 2016.

Roth D, Nelson DR, Bruchfeld A, Liapakis A, Silva M, Monsour H, Jr., et al. Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386(10003):1537-45.

Saxena V, Koraishy FM, Sise ME, Lim JK, Schmidt M, Chung RT, et al. Safety and efficacy of sofosbuvir-containing regimens in hepatitis C-infected patients with impaired renal function. Liver Int. 2016;36(6):807-16.

Mullins C, Thomas S, Pradel F, Bartlett S. The economic impact of laparoscopic living-donor nephrectomy on kidney transplantation. Transplantation. 2003;75(9):1505-12.

E.L. G, Pugatch D, Papatheodoridis G, Brau N, Brown A, Pol S, et al. In: Infection E-EaSoGPA-A-iPwRIaCHCVG-, editor. AASLD The Liver Meeting; Boston, MA2016.

Schold JD, Sehgal AR, Srinivas TR, Poggio ED, Navaneethan SD, Kaplan B. Marked variation of the association of ESRD duration before and after wait listing on kidney transplant outcomes. Am J Transplant. 2010;10(9):2008-16.

Belli LS, Berenguer M, Cortesi PA, Strazzabosco M, Rockenschaub SR, Martini S, et al. Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: A European study. J Hepatol. 2016;65(3):524-31.

Charlton M, Everson GT, Flamm SL, Kumar P, Landis C, Brown RS, Jr., et al. Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease. Gastroenterology. 2015;149(3):649-59.

Levitsky J, Formica RN, Bloom RD, Charlton M, Curry M, Friedewald J, et al. The American Society of Transplantation Consensus Conference on the Use of Hepatitis C Viremic Donors in Solid Organ Transplantation. Am J Transplant. 2017.




DOI: http://dx.doi.org/10.18103/imr.v3i9.570

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