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Infection. 2019 Feb;47(1):141-168. doi: 10.1007/s15010-018-1209-2. Epub 2018 Sep 25.

Management of hepatitis C virus infection in patients with chronic kidney disease: position statement of the joint committee of Italian association for the study of the liver (AISF), Italian society of internal medicine (SIMI), Italian society of infectious and tropical disease (SIMIT) and Italian society of nephrology (SIN).

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Division of Nephrology, Department of Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, University of Campania "Luigi Vanvitelli", Via M. Longo 50, 80138, Naples, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Division of Internal Medicine and Hepatology, Humanitas Clinical and Research Center, Milan, Italy.
Third Department of Infectious Diseases Azienda Ospedaliera Ospedali dei Colli, Naples, Italy.
Division of Nephrology, Maggiore Hospital and IRCCS Foundation, Milan, Italy.
Division of Nephrology, Azienda Ospedaliero-Universitaria Policlinico di Bari, Bari, Italy.
Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Infectious Disease Clinic, University of Bari, Bari, Italy.
Nephrology, Dialysis, and Transplantation, University of Genoa and Policlinico San Martino, Genoa, Italy.
Internal Medicine and Hepatology Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.
Department of Medical and Surgical Sciences, University Magna Græcia, Catanzaro, Italy.
Gastroenterology and Hepatology Unit, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
Division of Infectious Diseases, Niguarda Cà Granda Hospital, Milan, Italy.
Department of Medicina Clinica e Sperimentale, University of Messina, Messina, Italy.
Department of Emergency and Organ Transplantation, Section of Gastroenterology, University Hospital, Bari, Italy.
Department of Experimental and Clinical Medicine, Interdepartmental Hepatology Center MaSVE, University of Florence, Florence, Italy.


Hepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal patients. In the last few years, availability of more specific and effective drugs against HCV has dramatically changed the clinical course of this disease. These drugs may provide further advantages in the CKD population as a whole by reducing progression of renal disease, mortality rate and by increasing the survival of graft in renal transplant recipients. The strict pathogenetic and prognostic link between HCV infection and CKD requires an ongoing relationship among the healthcare professionals involved in the treatment of both HCV infection and CKD. Therefore, Scientific Societies involved in the care of this high-risk population in Italy have organized a joint expert panel. The aim of the panel is to produce a position statement that can be used in daily clinical practice for the management of HCV infected patients across the whole spectrum of renal disease, from the conservative phase to renal replacement treatments (dialysis and transplantation). Sharing specific evidence-based expertise of different professional healthcare is the first step to obtain a common ground of knowledge on which to instate a model for multidisciplinary management of this high-risk population. Statements cover seven areas including epidemiology of CKD, HCV-induced glomerular damage, HCV-related renal risk, staging of liver disease in patients with CKD, prevention of transmission of HCV in hemodialysis units, treatment of HCV infection and management of HCV in kidney transplantation.


Chronic kidney disease; Direct-acting antiviral agents; HCV in renal transplantation; HCV infection

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