| Theme | New Strategies to Control Viral Hepatitis in Dialysis Patients | |
|---|---|---|
| Title | New management to virus hepatitis indialysis patients：hepatitis virus infection and kidney transplantation | |
| Publish Date | 2009/08 | |
| Author | Tadahiko Tokumoto | Department of Urology, Kidney Center, TodaCentral General Hospital |
| Author | Takashi Akiba | Department of Blood Purification, Kidney Center,Tokyo Women's Medical University |
| Author | Kazunari Tanabe | Department of Urology, Tokyo Women's Medical University |
| [ Summary ] | The management due to the chronic viral hepatitis in kidney transplantation before and after is very important. In cases of hepatitis C virus (HCV) infection, the HCV antibody positive rate for chronic hemodialysis patients decreased from 15.95% of 1999 in our country, to 9.83% by the end of 2007. In general, interferon (IFN-alpha) has been used as the most conventional treatment for chronic hepatitis C infection. However, IFN response rates are high for genotype 1b patients. Therefore, combination therapy with ribavirin now plays a key role. Ribavirin is being mede available to the renal dysfunction patients who are with chronic renal failure（CRF）. Additionally, good results are obtained from IFN therapy after kidney transplantation for HCV hepatitis. However, it is necessary to administer therapy carefully to reduce risk of renal graftloss due to acute rejection associated with IFN. In relation to hepatitis B virus（HBV）infection, kidney transplant recipients have decreased survivalrates when they are HBs antigen-positive hemodialysis patients. However, hemodialysis is safe and effective and can improve prognoses with IFN and antiviral drugs（lamivudine, adefovir, entecavir）Adefovir and entecavir are new effective treatmentsfor lamivudine-resistant viruses. Thus, it is thought that the prognoses for HCV and HBV chronic hepatitis patients who are kidney transplant recipients can be considerably improved by these anti viral drugs. |
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