Renal yetmezlikli hepatit C hastalarının yönetimi

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.

Anahtar Kelimeler:

kronik hepatit C, ekstrahepatik bulgular, direkt etkili antiviral

Management of hepatitis C patients with kidney failure

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,

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