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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.