Risk Factors for Developments of Hepatitis C and its Treatment in Patients with End-Stage Renal Disease Treated by Hemodialysis

Hepatitis C virus (HCV) is a major cause of viral hepatitis in end-stage renal disease (ESRD) and imposes a major social and economic burden. Major risk factors for HCV transmission include organ transplantation, longer duration of Hemodialysis (HD) and the mode of dialysis. Previous studies blood transfusion was suggested as an important risk factor, but recent reports do not recognize blood transfusion as an independent risk factor in HCV spread among HD subjects. HCV screening for anti-HCV antibodies on admission and semiannually in HD patients is recommended for all HD patients. During the natural history of this disease, there is no association between the severity of histological changes and HCV-RNA levels and liver biopsy is the only accurate mean for assessing the severity. In HD patients, ribavirin is not recommended for patients with a glomerular filtration <50ml/min/1.73m2. Pegylated interferon is also not recommended in patients with renal insufficiency. IFN-α monotherapy remains the treatment of choice in these patients.