Immunology of HeV and HEV in Renal Failure and Transplantation

Viral hepatitis has a special relationship to renal diseases. Hepatitis Band C viruses (HBV and HCV) infections are more prevalent in renal failure patients than in general population, an important cause of morbidity and mortality of renal failure patients on chronic dialysis and after renal transplantation. The association is largely due to the frequent use of blood products in patients with end-stage kidney diseases and multiple invasive medical procedures to which these patients are exposed. The effects of renal failure on the general health and immune status of patients with renal diseases also make viral hepatitis more difficult to diagnose as well as to manage. Finally, there have been few studies of the natural history and therapy of viral hepatitis in renal failure patients, making conclusionsdifficult. This paper will review the prevalence, incidence, clinical features, and natural histories of HBV and HCV infections and suggest recommendations for management and therapy in renal failure patients and patients undergoing renal transplantation.