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Hepatitis-C-Therapie vor und nach Nierentransplantation

Was ist heute möglich?

Hepatitis C treatment before and after kidney transplantation

What is currently possible?

  • Leitthema
  • Published:
Die Nephrologie Aims and scope

Zusammenfassung

Die Einführung der DAA („direct acting antiviral agents“) führte zu einem Paradigmenwechsel in der Behandlung der Hepatitis-C-Virus(HCV)-Infektion. Insbesondere nierentransplantierte Patienten mit einer HCV-Infektion profitieren heute von der nebenwirkungsarmen DAA-Therapie mit hohen Heilungsraten von über 95 %. Die neuen KDIGO(Kidney Disease: Improving Global Outcomes)-Leitlinien von 2022 sprechen sich sogar für die Transplantation von HCV-virämischen Nieren bei HCV-naiven Empfängern aus, wenn eine frühe postoperative DAA-Therapie für 4 bis maximal 12 Wochen verabreicht wird. Diese Arbeit setzt sich mit den Risiken einer HCV-Infektion vor und nach einer Nierentransplantation auseinander, beleuchtet die Chancen und Risiken einer DAA-Therapie für nierentransplantierte Patienten und weist auf Besonderheiten und Grenzen hin.

Abstract

The implementation of direct acting antiviral agents (DAA) led to a paradigm shift in the treatment of hepatitis C virus (HCV) infections. Kidney transplant patients with HCV infections in particular nowadays benefit from DAA treatment with few side effects and high cure rates over 95%. The new Kidney Disease: Improving Global Outcomes (KDIGO) guidelines from 2022 even advocate the transplantation of HCV viremic kidneys into HCV-naïve recipients if early postoperative DAA treatment is administered for 4 weeks up to a maximum of 12 weeks. This article reviews the risks of HCV infections before and after renal transplantation, highlights the opportunities and risks of DAA treatment for kidney transplant recipients and draws attention to special characteristics and limitations.

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Authors and Affiliations

  1. Klinik für Gastroenterologie, Hepatologie, Infektiologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    Julia Carolin Eichholz &  Benjamin Maasoumy

  2. Klinik für Nephrologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    Justa Friebus-Kardash &  Ute Eisenberger

  3. Center for Individualized Infection Medicine (CIIM), Hannover, Deutschland

    Benjamin Maasoumy

  4. Klinik für Innere Medizin II, Nephrologie und Rheumatologie, Knappschaftskrankenhaus Bottrop, Osterfelder Str. 155a, 46242, Bottrop, Deutschland

    Ute Eisenberger

Authors
  1. Julia Carolin Eichholz
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  2. Justa Friebus-Kardash
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  3. Benjamin Maasoumy
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  4. Ute Eisenberger
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Correspondence to Benjamin Maasoumy or Ute Eisenberger.

Ethics declarations

Interessenkonflikt

B. Maasoumy erhält Honorare für Vorträge und Beratung von MSD, Falk, AbbVie, Astellas, Fortbildungskolleg, Medical Tribune, Luvos, Roche, Norgine, Gilead und Fujirebio sowie Forschungsgelder von Fujirebio, Altona Diagnostics, Roche und EWIMED. J.C. Eichholz, J. Friebus-Kardash und U. Eisenberger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Gunilla Einecke, Göttingen

Ute Eisenberger, Bottrop

Kevin Schulte, Kiel

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Eichholz, J.C., Friebus-Kardash, J., Maasoumy, B. et al. Hepatitis-C-Therapie vor und nach Nierentransplantation. Nephrologie 19, 87–94 (2024). https://doi.org/10.1007/s11560-023-00709-8

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