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Thématique :
- Foie
Originalité :
Réexamen
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2017/11  
 
  2017 Sep  
  doi: 10.1002/hep.29505.  
 
  Chronic Hepatitis C Virus (HCV) Increases the Risk of Chronic Kidney Disease (CKD) While Effective HCV Treatment Decreases the Incidence of CKD  
 
  Park H, Chen C, Wang W, Henry L, Cook RL, Nelson DR  
  https://www.ncbi.nlm.nih.gov/pubmed/28873225  
 
 

Abstract

We assessed the risk of chronic kidney disease (CKD) in chronic hepatitis C virus (HCV)-infected patients and the incidence reduction of CKD after receipt of HCV treatment. We also evaluated the risk of membranoproliferative glomerulonephritis (MPGN) and cryoglobulinemia in chronic HCV patients. A retrospective cohort analysis of the Truven Health MarketScan Database (2008-2015) in the United States was conducted. In a cohort of 56,448 HCV-infected patients and 169,344 propensity score (1:3)-matched non-HCV patients, we examined the association of HCV infection with the incidence of CKD. Of 55,818 HCV patients, 6.6 % (n = 3666), 6.3% (n = 3534), and 8.3% (n = 4628) patients received either interferon-based dual, triple, or all-oral direct acting antiviral agent therapy, respectively, whereas 79% of patients did not receive any HCV treatment. Cox proportional hazards models were used to compare the risk of developing CKD in HCV patients compared with non-HCV patients and treated patients compared with untreated HCV patients. In a multivariate time-varying Cox regression model, HCV-infected patients had a 27% increased risk of CKD compared with non-HCV patients (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.18-1.37). Among HCV patients, individuals who received the minimally effective HCV treatment for dual, triple, or all-oral therapy had a 30% decreased risk of developing CKD (HR, 0.70; 95% CI, 0.55-0.88). In addition, HCV-infected patients experienced a twofold and a nearly 17-fold higher risk of MPGN (HR, 2.23; 95% CI, 1.84-2.71) and cryoglobulinemia (HR, 16.91; 95% CI, 12.00-23.81) respectively, compared with non-HCV patients.

CONCLUSION:

HCV-infected individuals in the United States are at greater risk of developing CKD, MPGN, and cryoglobulinemia. Minimally effective treatment of HCV infection can prevent the development of CKD, although the association was not significant for all-oral therapy. (Hepatology 2017).

 

 
Question posée
 
Incidence de l’insuffisance rénale chez les patients américains infectés par le VHC ainsi que l’incidence la glomérulopathie membrano-proliférative (MPGN) et de la cryoglobulinémie et l’impact du traitement anti-VHC sur ce taux incident d’insuffisance rénale.
 
Question posée
 
À partir d’une cohorte rétrospective américaine, il est montré que ces patients infectés par le VHC sont à plus grand risque d’insuffisance rénale, de MPGN et de cryoglobulinémie avec un rôle préventif de certains traitements anti-viraux.
 
Commentaires

Influence bien démontrée du VHC sur le rein même chez les américains alors que les études n’étaient pas concordantes.

 
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