Prevention and treatment of viral hepatitis in renal failure

Viral hepatotropic infections may lead to diagnostic and therapeutic proble ms in hemodialysis patients and kidney recipients. The parenteral and commu nity-acquired routes of contamination of hepatitis B and C viruses explain their high frequency in this population. Their impact because the immunosup pressive treatments, is harmful with a decrease in patients and allografts survival; cirrhosis is a contra-indication for renal transplantation since associated with a bad short-term prognosis and may require a combined kidne y-liver transplantation. Thus, a liver biopsy is recommended in order to ev aluate the histopathological severity of the liver disease (stage and grade ) and to precise if an antiviral treatment appears necessary, especially be cause interferon-a, the main treatment of hepatitis B and C infections, is contra-indicated in kidney recipients because of the risk of graft rejectio n. In summary, the diagnosis of viral hepatotropic infections has to be ear ly undergone and its pathological impact has to be evaluated by a liver bio psy. The best treatment has to be prophylactic (vaccination against hepatit is B virus and the respect of universal hygiene rules for hepatitis C virus ).