Friday, September 28, 2018

Hepatitis C Infection May Be a Blessing for Patients in Need of a Transplant

Hepatitis C Infection May Be a Blessing for Patients in Need of a Transplant
Lara C. Pullen PHD
First published: 27 September 2018
https://doi.org/10.1111/ajt.15091

This month's installment of “The AJT Report” looks at how transplanting HCV‐positive organs can reduce risks for patients awaiting organs. We also report on Bristol Myers Squibb's recent easement of restrictions in prescribing belatacept (Nulojix).

“We are very proactive about our hepatitis C patients,” says Uttam Reddy, MD, medical director of the kidney transplant program at the University of California, Irvine (UCI) Medical Center. This is because in Southern California, the average wait time for a hepatitis C virus (HCV)‐negative organ is 8 to 10 years. If, however, a patient with HCV is willing to receive an HCV‐positive organ, the typical wait time is less than two years, a difference that Dr. Reddy describes as a “notably significant benefit.” In fact, he adds, “Before treating HCV in patients with advanced kidney disease, we recommend that they be evaluated at UCI first to assess the degree of their liver disease. If their liver disease is not advanced, we recommend proceeding with transplant and then treating their HCV after transplantation.”

Key Points
• Hepatitis C virus (HCV)-positive patients who elect to receive HCV-positive organs may cut years off their wait time.
• While the risk from an HCV-positive organ is dif´Čücult to quantify, it needs to be weighed against known risk from years on dialysis.
• Direct-acting antivirals (DAAs) lower risks associated with receiving HCV-positive organs.
• More frequent HCV diagnoses, greater use of DAAs and a potential ebbing of the opioid epidemic mean that fewer HCV-positive organs will be available in the future.

Read online: https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.15091

Download PDF: https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajt.15091

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