Viral hepatitis in hemodialysis and renal transplantation patients
Pol, S.; Legendre, C.
Nephrologie 15(3): 191-195
1994
ISSN/ISBN: 0250-4960 PMID: 7969710 Document Number: 431783
In patients with chronic renal failure be they hemodialysed or transplanted, viral hepatitis B and C tend to progress towards chronicity, in spite of both a frequent silent clinical presentation and an atypical course of viral markers. Therefore, only liver biopsy will allow a precise diagnosis of liver disease in these patients. Immunosuppression clearly modifies natural history of B and C viral hepatitis, but their real impact at mid and long-term on patient survival is still a matter of debate. Treatment is firstly preventive (vaccination and isolation of infected patients in dialysis units) and secondly curative. Preliminary data suggest that antiviral drugs such as ARA-AMP and interferon-alpha may have the same efficacy as in non-immunosuppressed patients. It is therefore of urgent need to evaluate both efficacy and tolerance of these antiviral drugs in patients on hemodialysis and in kidney transplant recipients.