Université Paris Descartes, AP-HP, hôpital Cochin, Unité d’hépatologie, Inserm U 1016, 75014 Paris, France
Hepatotropic virus infections have some specificities in dialyzed patients. The prevalence of some of them are higher than in the general population and their evolution could differ according to the severity of renal insufficiency. Therapeutic indications and available drugs are modified by the nephrologic context and the project of kidney transplantation. The management has drastically improved during the last 20 years with some preventives means (screening of blood products, early vaccination, and the respect of universal hygienic precautions), the availability of nucleoside or nucleotide analogs efficient for patients with chronic hepatitis B, the identification of chronic E hepatitis in immunodeficient patients and the approval of direct antiviral agents allowing obtaining a viral eradication in more than 95% of cases of hepatitis C. Thanks to these means, it is possible to treat hepatitis B, C and E and to prevent hepatitis A, B and D, to decrease the risk of cirrhosis. As for non-dialyzed population, the unmet needs are the development of more efficient treatments for hepatitis D and to develop shorter therapies against hepatitis B, compatible with terminal renal insufficiency.
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