Renal yetmezlikli hepatit C hastalarının yönetimi

Year 2019, , 577 - 584, 01.12.2019

Emine Parlak

https://doi.org/10.21601/ortadogutipdergisi.479176

Abstract

Kronik Hepatit C (KHC) infeksiyonu önemli bir sağlık problemidir. Dünyada 185 milyon insanı etkilemiştir. Hastalarda fibroz, siroz, karaciğer yetmezliği, karaciğer kanseri gibi komplikasyonlar gelişebilir. Özellikle hepatit C virüsü (HCV) karaciğer dışı tutulumlarla da seyredebilir. Bu hastaların üçte ikisinde en az bir extrahepatik bulgu (EHB) izlenmektedir. EHB her zaman karaciğer hastalığı bulguları ile birlikte görülmez. Hatta kronik viral hepatit klinik bulgularından önce EHB çıkabilmektedir. Dikkatli yapılan sistematik muayene ile HCV tanısı daha erken konulabilir. Kronik HCV’de böbrek hastalıkları, otoimmun hastalıklar, hematolojik hastalıklar, diabet, kardiomyopati gibi EHB ile karşılaşabiliriz. EHB morbidite ve mortalite nedeni olabilir. Güncel etkili, oral, güvenilir direkt etkili antiviral (DEA) ilaçlar birincil tercih edilen ilaçlardır. Bu ilaçlara ulaşabilen HCV hastalarında sürekli virolojik yanıta (SVR) ulaşılabilmektedir. Yüksek başarı oranı sağlanmaktadır. Bu raporda HCV infeksiyonun güncel durumu, ekstrahepatik bulgular, renal yetmezlikte güncel yeni tedavi tercihlerine değinilecektir.

Keywords

kronik hepatit C, ekstrahepatik bulgular, direkt etkili antiviral

Management of hepatitis C patients with kidney failure

Abstract

Chronic hepatitis C (CHC) infection is a significant health problem that affects 185 million people worldwide. Complications such as fibrosis, cirrhosis, liver failure and liver cancer may also develop. The hepatitis C virus (HCV) may also progress with non-hepatic involvement. At least one extrahepatic manifestation (EHM) is observed in two out of three of these patients. EHMs may not always be seen together with liver disease findings, and may even appear before clinical chronic viral hepatitis findings. HCV can be diagnosed earlier by means of careful systematic examination. EHMs such as kidney diseases, autoimmune diseases, hematological diseases, diabetes and cardiomyopathy may be encountered in chronic HCV. EHMs can cause morbidity and mortality. Contemporary effective, oral, direct-acting antiviral (DAA) drugs are the first-choice medications. Sustained virological response (SVR) and a high success rate can be achieved in HCV patients with access to these drugs. This report discusses the current status of HCV infection, EHMs, and the available therapeutic options in the treatment of renal failure.

Keywords

chronic hepatitis C, extrahepatic manifestation, direct-acting antiviral

References

• Tabak F. Kronik hepatit C’de güncel tedavi. ANKEM Derg. 2013;27(Ek 2):135-136.
• Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013;57:1333–1342.
• Türk Karaciğer Araştırmaları Derneği Ulusal Hepatit Sıklığı Çalışması (TÜRKHEP 2010) www.tasl.org.tr/dosya/tasl Ulusal Hepatit Sıklığı Çalışması. ‎
• Yildirim B, Barut S, Bulut Y, et al. Seroprevalence of hepatitis B and C viruses in the province of Tokat in the Black Sea region of Turkey: A population-based study. Turk J Gastroenterol. 2009;20(1):27-30.
• Senaka Peter, Craig Solid, Tanya Bovitz, Haifeng Guo, Allan J. Collins, Jean Marie Arduino. Hepatitis C and renal disease: differences in patient characteristics and clinical outcomes in the United States. Hepatology 2015; 62(suppl):1120A; (poster 1867)
• Kidney Disease: Improving. Global Outcomes. KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of Hepatitis C in chronic kidney disease. Kidney International. 2008;73 (Suppl 109):1–99.
• Oruç A, Ersoy A. Kronik böbrek hastalığında hepatit C virüs enfeksiyonunun tedavisinde güncel yaklaşımlar. Turk Neph Dial Transpl. 2016;25(Ek / Suppl 1):31-40.
• Mıstık R, Balık İ. Türkiye’de viral hepatitlerin epidemiyolojik analizi. Ed. Tekeli E, Balık İ. Viral Hepatit. 1. Baskı. Karakter Color A.Ş. Viral Hepatitle Savaşım Derneği Yayını, 2003:9-55.
• Türk Nefroloji Derneği merkezlerden gelen bilgilerin analizi dönem 2003, http://www.tsn.org.tr/registry/ Registry_2003.pdf
• Koksal I. Pegylated interferon for treatment in hemodialysis patients with chronic hepatitis C. J Gastroenterol Hepatol. 2006 Mar;21(3):491-494.
• Türk Nefroloji Derneği merkezlerden gelen bilgilerin analizi, dönem 2014. T.C. Sağlık Bakanlığı Ve Türk Nefroloji Derneği Ortak Raporu, Ankara. 2015: Türk Nefroloji Derneği Yayınları.
• Finelli L, Miller JT, Tokars JI, Alter MJ, Arduino MJ. National surveillance of dialysis-associated diseases in the United States, 2002. Semin Dial. 2005;18:52-61.
• Alter J, Tokars JI, Arduina MJ, Favero MS. Nosocomial infections with hemodialysis. In: Mayhall CG (ed). Hospital Epidemiology and Infection Control. 3 rd ed. Philadelphia: Lippincott Williams & Wilkins, 2004:1139-1160.
• Kheirabad K, Bahri F, Kargar M, Ghasemzadeh I. Hepatitis C and G Virus Infection Prevalence Among Hemodialysis Patients and Associated Risk Factors in the Hormozgan Province of Southern Iran. Hepat Mon. 2016;13;16(10):e40375.
• CDC Recommendations for Preventing Transmission of Infections among Chronic Hemodialysis Patients. MMWR 2001;50(RR05):1-43.
• Huang CC. Hepatitis in patients with end-stage renal disease. J Gastroenterol Hepatology. 1997;12(9-10):236-241.
• Lerouxs-Roels G, Dhondt A. Hepatitis and dialysis. Infectious problems in dialysis patients. In: Lameire N, Mehta RL (eds). Complications of Dialysis. New York: Marcel Dekker, 2000:673-696.
• Strader DB, Wright T, Thomas DL, Seeff LB. American Association for the Study of Liver Diseases. Diagnosis, Management, and Treatment of Hepatitis C. Hepatology. 2004;39(4):1147-1171.
• Ergünay K, Sener B, Alp A, Karakaya J, Hascelik G. Utility of commercial quantitative hepatitis C virus core antigen assay in a diagnostic laboratory setting. Diagn Microbiol. Infect. Dis. 2011;70:486-491.
• Cacoub P, Renou C, Rosenthal E, Cohen P, Loury I, Loustaud-Ratti V, Yamamoto AM, Camproux AC, Hausfater P, Musset L, Veyssier P, Raguin G, Piette JC. Extrahepatic manifestations associated with hepatitis C virus infection. A prospective multicenter study of 321 patients. The GERMIVIC. Groupe d’Etude et de Recherche en Medecine Interne et Maladies Infectieuses sur le Virus de l’Hepatite C. Medicine (Baltimore). 2000;79(1):47-56.
• Adinolfi LE, Nevola R, Lus G, Restivo L, Guerrera B, Romano C, Zampino R, Rinaldi L, Sellitto A, Giordano M, Marrone A. Chronic hepatitis C virus infection and neurological and psychiatric disorders: an overview. World J Gastroenterol. 2015; 28;21(8):2269-2280.
• Hofnagle JH. Course and outcome of hepatitis C. Hepatology. 2002;36(S1):21-29.
• Agnello V, Chung RT, Kaplan LM. Arole for hepatitis C virus infection in type II cryogloblunemi. N. Engl. J. Med 1992;19;327(21):1490-1495.
• Zignego AL, Ferri C, Pileri SA, Caini P, Bianchi FB. Extrahepatic manifestations of Hepatitis C Virus infection: a general overview and guidelines for a clinical approach. Italian Association of the Study of Liver Commission on Extrahepatic Manifestations of HCV infection. Dig Liver Dis. 2007;39(1):2-17.
• Fabrizi F, Piergiorgio M, Martin P. The Unravelled Link between Chronic Kidney Disease and Hepatitis C Infection. New Journal of Science 2014. Article ID 180203. (doi: 10.1155/2014/180203).
• Lucas GM, et al. Hepatitis C Viremia and the Risk of Chronic Kidney Disease in HIV-Infected Individuals. J Inf Dis 2013;208:1240–1249.
• Cholongitas E, Pipili C, Papatheodoridis GV. Interferon-free regimens in patients with hepatitis C infection and renal dysfunction or kidney transplantation. World J Hepatol. 2017;8;9(4):180-190.
• Jadoul M, Martin P. Hepatitis C Treatment in Chronic Kidney Disease Patients: The Kidney Disease Improving Global Outcomes Perspective. Blood Purif. 2017;43(1-3):206-209.
• KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int Suppl. 2008;(109):1-99.
• Carrion AF, Fabrizi F, Martin P. Should ribavirin be used to treat hepatitis C in dialysis patients? Semin Dial. 2011;24(3):272-274.
• Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function-measured and estimated glomerular filtration rate. N Engl J Med. 2006;8;354(23):2473-83.
• Singh T, Guirguis J, Anthony S, Rivas J, Hanouneh IA, Alkhouri N. Sofosbuvir-based treatment is safe and effective in patients with chronic hepatitis C infection and end stage renal disease: a case series. Liver Int. 2016;36(6):802-806.
• Dumortier J, Bailly F, Pageaux GP, Vallet-Pichard A, Radenne S, Habersetzer F, Gagnieu MC, Grangé JD, Minello A, Guillaud O, Kamar N, Alric L, Leroy V. Sofosbuvir-based antiviral therapy in hepatitis C virus patients with severe renal failure. Nephrol Dial Transplant. 2017;1;32(12):2065-2071.
• Saxena, EASL, 2015, LP08. Journal of Hepatology 2015;63:763-773.
• Suda G, Ogawa K, Kimura M, Nakai M,Sho T, Morikawa K, Sakamoto N. Novel Treatment of Hepatitis C Virus Infection for Patients with Renal Impairment. J Clin Transl Hepatol 2016;4:320–327.
• Kiser JJ, Burton JR Jr, Everson GT. Drug-drug interactions during antiviral therapy for chronic hepatitis C. Nat Rev Gastroenterol Hepatol. 2013;10(10):596-606.
• Gómeza RM, Rincónb D, Hernándezc E, Ahumadab A, Valderasb P, Izquierdod S, Devesad MJ, Fernándeze C, Gutiérreze ML, Ortizf M, Calvog M, Castellanoae G, Fernández I. Estudıo multıcéntrıco sobre la efıcacıa ysegurıdad en práctıca clínıca del tratamıento con ombıtasvır/parıtaprevır/rıtonavır más dasabuvır en pacıentes con ınsufıcıencıa renal grave o nefropatía termınal e ınfeccıón por el vhc gt1 y 4. 41st. Congreso Anual AEEH. 17-19 Feb, 2016. Madrid, Spain. P#105. P-105.
• Efficacy and safety of HCV-treatment wıth Dırect-Actıng Antıviral Agents Interferon-Free, ın patients with severe renal impairment ın clinical practice. EASL 2016, p. 179.
• Kohli A, Alshati A, Georgie F, Manch R, Gish RG. Direct-acting antivirals for the treatment of chronic hepatitis C in patients with chronic kidney disease. Therap Adv Gastroenterol. 2016;9(6):887–897.
• Papudesu C, Kottilil S, Bagchi S. Elbasvir/grazoprevir for treatment of chronic hepatitis C virus infection. Hepatol Int. 2017;11(2):152-160.
• 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;386:1537–1545.
• Suda G, Kudo M, Nagasaka A, Furuya K, Yamamoto Y, Kobayashi T, et al. Efficacy and safety of daclatasvir and asunaprevir combination therapy in chronic hemodialysis patients with chronic hepatitis C. J Gastroenterol. 2016;51:733–740.
• Toyoda H, Kumada T, Tada T, Takaguchi K, Ishikawa T, Tsuji K, et al. Safety and efficacy of dual direct-acting antiviral therapy (daclatasvir and asunaprevir) for chronic hepatitis C virus genotype 1 infection in patients on hemodialysis. J Gastroenterol 2016;51:741–747.
• EASL Recommendations on Treatment of Hepatitis C 2016. J Hepatol (2016), https://doi.org/10.1016/j.jhep.2016.09.001 (Şubat 2018).
• Kosloski MP, Zhao W, Marbury TC, Preston RA, Collins MG, Pugatch D, Mensa F, Kort J, Liu W. Effects of Renal Impairment and Hemodialysis on the Pharmacokinetics and Safety of the Glecaprevir and Pibrentasvir Combination in HCV-Negative Subjects. Antimicrob Agents Chemother. 2017 Dec 20. pii: AAC.01990-17. (doi: 10.1128/AAC.01990-17).
• The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America Present. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C Recommendations for Testing, Managing and Treating Hepatitis C, 2018. at: http://www.hcvguidelines.org Last Updated: September 21, 2017.
• Türkiye Viral Hepatitler Tanı ve Tedavi Kılavuzu 2017.
• Sağlık uygulama tebliği (SUT) 25 Mart 2017 CUMARTESİ Resmî Gazete Sayı: 30018.