New Insights Into Optimal Timing of Hepatitis C Virus Treatment for Dialysis Patients Waitlisted for Kidney Transplant
Authors: David S. Goldberg, Peter P. Reese
Journal: Annals of Internal Medicine (2018)

Editorials21 August 2018New Insights Into Optimal Timing of Hepatitis C Virus Treatment for Dialysis Patients Waitlisted for Kidney TransplantDavid S. Goldberg, MD, MSCE and Peter P. Reese, MD, MSCEDavid S. Goldberg, MD, MSCEPerelman School of Medicine, Philadelphia, Pennsylvania (D.S.G., P.P.R.)Search for more papers by this author and Peter P. Reese, MD, MSCEPerelman School of Medicine, Philadelphia, Pennsylvania (D.S.G., P.P.R.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1718 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Direct-acting antiviral (DAA) therapies are highly effective at curing hepatitis C virus (HCV) infection (cure rates >95%) and have manageable side effects but high costs (1). An estimated 6% of patients receiving long-term dialysis in the United States are seropositive for HCV. In the interferon era, many of these patients either never received or were not cured by HCV treatment (2). Because of the opioid crisis, HCV infection is increasingly common among organ donors; as many as 25% of all deceased donors are HCV-seropositive in New England and other regions (3). Patients receiving dialysis who are willing to accept HCV-infected ...References1. Zeuzem S, Ghalib R, Reddy KR, Pockros PJ, BenAri Z, Zhao Y, et al. Grazoprevir-elbasvir combination therapy for treatment-naive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection: a randomized trial. Ann Intern Med. 2015;163:1-13. [PMID: 25909356]. doi:10.7326/M15-0785 LinkGoogle Scholar2. Goodkin DA, Bieber B, Jadoul M, Martin P, Kanda E, Pisoni RL. Mortality, hospitalization, and quality of life among patients with hepatitis C infection on hemodialysis. Clin J Am Soc Nephrol. 2017;12:287-97. [PMID: 27908905] doi:10.2215/CJN.07940716 CrossrefMedlineGoogle Scholar3. Goldberg DS, Blumberg E, McCauley M, Abt P, Levine M. Improving organ utilization to help overcome the tragedies of the opioid epidemic. Am J Transplant. 2016;16:2836-41. [PMID: 27438538] doi:10.1111/ajt.13971 CrossrefMedlineGoogle Scholar4. Eckman MH, Woodle ES, Thakar CV, Paterno F, Sherman KE. Transplanting hepatitis C virus–infected versus uninfected kidneys into hepatitis C virus–infected recipients. A cost-effectiveness analysis. Ann Intern Med. 2018;169:214-23. doi:10.7326/M17-3088 LinkGoogle Scholar5. Hoefs JC, Shiffman ML, Goodman ZD, Kleiner DE, Dienstag JL, Stoddard AM; HALT-C Trial Group. Rate of progression of hepatic fibrosis in patients with chronic hepatitis C: results from the HALT-C Trial. Gastroenterology. 2011;141:900-8. [PMID: 21699796] doi:10.1053/j.gastro.2011.06.007 CrossrefMedlineGoogle Scholar6. Kiberd BA, Doucette K, Vinson AJ, Tennankore KK. Hepatitis C virus-infected kidney waitlist patients: treat now or treat later? Am J Transplant. 2018. [PMID: 29687948] doi:10.1111/ajt.14891 CrossrefMedlineGoogle Scholar7. Reese PP, Harhay MN, Abt PL, Levine MH, Halpern SD. New solutions to reduce discard of kidneys donated for transplantation. J Am Soc Nephrol. 2016;27:973-80. [PMID: 26369343] doi:10.1681/ASN.2015010023 CrossrefMedlineGoogle Scholar8. Goldberg DS, Abt PL, Blumberg EA, VanDeerlin VM, Levine M, Reddy KR, et al. Trial of transplantation of HCV-infected kidneys into uninfected recipients [Letter]. N Engl J Med. 2017;376:2394-5. [PMID: 28459186] doi:10.1056/NEJMc1705221 CrossrefMedlineGoogle Scholar9. Durand CM, Bowring MG, Brown DM, Chattergoon MA, Massaccesi G, Bair N, et al. Direct-acting antiviral prophylaxis in kidney transplantation from hepatitis C virus-infected donors to noninfected recipients: an open-label nonrandomized trial. Ann Intern Med. 2018;168:533-40. [PMID: 29507971]. doi:10.7326/M17-2871 LinkGoogle Scholar10. Fabrizi F, Messa P. Transmission of hepatitis C virus in dialysis units: a systematic review of reports on outbreaks. Int J Artif Organs. 2015;38:471-80. [PMID: 26449566] doi:10.5301/ijao.5000437 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Perelman School of Medicine, Philadelphia, Pennsylvania (D.S.G., P.P.R.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1718.Corresponding Author: David S. Goldberg, MD, MSCE, Center for Clinical Epidemiology and Biostatistics, 730 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104; e-mail, david.[email protected]upenn.edu.Current Author Addresses: Dr. Goldberg: Center for Clinical Epidemiology and Biostatistics, 730 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104.Dr. Reese: Center for Clinical Epidemiology and Biostatistics, 917 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104.This article was published at Annals.org on 10 July 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTransplanting Hepatitis C Virus–Infected Versus Uninfected Kidneys Into Hepatitis C Virus–Infected Recipients Mark H. Eckman , E. Steve Woodle , Charuhas V. Thakar , Flavio Paterno , and Kenneth E. Sherman Metrics Cited byHCV in the haemodialysis population: Treat now or later?A Patient Decision Support Tool for Hepatitis C Virus and CKD TreatmentTransplanting Hepatitis C Virus–Infected or Uninfected Kidneys Into Hepatitis C Virus–Infected RecipientsBryce Kiberd, MD, Karen Doucette, MD, Amanda Vinson, BSc, SM, MD, and Karthik Tennankore, MD 21 August 2018Volume 169, Issue 4Page: 256-257KeywordsBiostatisticsClinical epidemiologyHepatitis C virusKidneysLiver fibrosisMedical dialysisOpioidsPatientsQuality adjusted life yearsRenal transplantation ePublished: 10 July 2018 Issue Published: 21 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...