, Volume 47, Issue 1, pp 141–168 | Cite as

Management of hepatitis C virus infection in patients with chronic kidney disease: position statement of the joint committee of Italian association for the study of the liver (AISF), Italian society of internal medicine (SIMI), Italian society of infectious and tropical disease (SIMIT) and Italian society of nephrology (SIN)

  • Roberto MinutoloEmail author
  • Alessio Aghemo
  • Antonio Chirianni
  • Fabrizio Fabrizi
  • Loreto Gesualdo
  • Edoardo G. Giannini
  • Paolo Maggi
  • Vincenzo Montinaro
  • Ernesto Paoletti
  • Marcello Persico
  • Francesco Perticone
  • Salvatore Petta
  • Massimo Puoti
  • Giovanni Raimondo
  • Maria Rendina
  • Anna Linda Zignego
  • on behalf of the Italian Society of Nephrology (SIN)
  • the Italian Association for the Study of the Liver (AISF)
  • the Italian Society of Infectious and Tropical Disease (SIMIT)
  • the Italian Society of Internal Medicine (SIMI)
Position Papers and Guidelines


Hepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal patients. In the last few years, availability of more specific and effective drugs against HCV has dramatically changed the clinical course of this disease. These drugs may provide further advantages in the CKD population as a whole by reducing progression of renal disease, mortality rate and by increasing the survival of graft in renal transplant recipients. The strict pathogenetic and prognostic link between HCV infection and CKD requires an ongoing relationship among the healthcare professionals involved in the treatment of both HCV infection and CKD. Therefore, Scientific Societies involved in the care of this high-risk population in Italy have organized a joint expert panel. The aim of the panel is to produce a position statement that can be used in daily clinical practice for the management of HCV infected patients across the whole spectrum of renal disease, from the conservative phase to renal replacement treatments (dialysis and transplantation). Sharing specific evidence-based expertise of different professional healthcare is the first step to obtain a common ground of knowledge on which to instate a model for multidisciplinary management of this high-risk population. Statements cover seven areas including epidemiology of CKD, HCV-induced glomerular damage, HCV-related renal risk, staging of liver disease in patients with CKD, prevention of transmission of HCV in hemodialysis units, treatment of HCV infection and management of HCV in kidney transplantation.


HCV infection Chronic kidney disease Direct-acting antiviral agents HCV in renal transplantation 



No financial support was received in the preparation of this manuscript.

Compliance with ethical standards

Conflict of interest

Roberto Minutolo has received speaker honoraria/consultant fees from Abbvie. Alessio Aghemo has received speaker honoraria/ consultant fees/travel grants from Abbvie, Gilead, MSD, Janssen, BMS, Alfasigma and research grants from Gilead and Abbvie. Antonio Chirianni has received speaker honoraria/ consultant fees from Gilead, AbbVie, BMS, MSD. Fabrizio Fabrizi has received consultant fees from Abbvie and MSD. Loreto Gesualdo has no conflict of interest to declare. Edoardo G. Giannini has received speaker honoraria/consultant fees from AbbVie, Bayer, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Janssen Cilag, MSD, and Novartis. Paolo Maggi has received honoraria/ consultant fees/travel grants from Abbvie, Gilead, MSD, Janssen, BMS, ViiV. Vincenzo Montinaro has received speaker honoraria/travel grants from Abbvie, Janssen, ViiV Healthcare, Alexion, Shire, CSL Behring. Ernesto Paoletti has received consultant fees from Abbvie, Novartis, Vifor Fresenius Pharma. Marcello Persico has received speaker honoraria from Abbvie, BMS, Gilead, MSD. Francesco Perticone has no conflict of interest to declare. Salvatore Petta has received speaker honoraria/ consultant fees/travel grants from Abbvie, BMS, Gilead, Intercept, MSD, Polifarma, Tobira. Massimo Puoti has received speaker honoraria from Abbvie Gilead sciences MSD and research grants from Gilead sciences. Giovanni Raimondo has received speaker honoraria/consultant fees from Abbvie, BMS, Gilead Science, Janssen Cilag, MSD, Bayer, and research grants from Abbvie, BMS, Gilead Science. Maria Rendina has received speaker honoraria/consultant fees/travel grants from Abbvie, Gilead, MSD, BMS, Kedrion, Biotest, Griffons, Astellas, Novartis. Anna Linda Zignego has received speaker honoraria/consulting fees from Abbvie, Gilead, MSD, Janssen, BMS.

Research involving human participants and/or animals

For this type of study formal consent is not required.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study Informed consent is not required.


  1. 1.
    Kidney Disease (2013) Improving global outcomes (KDIGO) CKD Work Group. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 3:1–150Google Scholar
  2. 2.
    De Nicola L, Donfrancesco C, Minutolo R et al (2015) Prevalence and cardiovascular risk profile of chronic kidney disease in Italy: results of the 2008–12 National Health Examination Survey. Nephrol Dial Transpl 30:806–814Google Scholar
  3. 3.
    Gentile G, Postorino M, Mooring RD et al (2009) Estimated GFR reporting is not sufficient to allow detection of chronic kidney disease in an Italian regional hospital. BMC Nephrol 10:24Google Scholar
  4. 4.
    Minutolo R, De Nicola L, Mazzaglia G et al (2008) Detection and awareness of moderate to advanced CKD by primary care practitioners: a cross sectional study from Italy. Am J Kidney Dis 52:444–453Google Scholar
  5. 5.
    Li WC, Lee YY, Chen IC, Wang SH, Hsiao CT, Loke SS (2014) Age and gender differences in the relationship between hepatitis C infection and all stages of chronic kidney disease. J Viral Hepat 21:706–715Google Scholar
  6. 6.
    Satapathy SK, Lingisetty CS, Williams S (2012) Higher prevalence of chronic kidney disease and shorter renal survival in patients with chronic hepatitis C virus infection. Hepatol Int 6:369–378Google Scholar
  7. 7.
    Tong X, Spradling PR (2015) Increase in nonhepatic diagnoses among persons with hepatitis C hospitalized for any cause, United States, 2004–2011. J Viral Hepat 22:906–913Google Scholar
  8. 8.
    Rognant N, Lemoine S (2014) Evaluation of renal function in patients with cirrhosis: where are we now? World J Gastroenterol 20:2533–2541Google Scholar
  9. 9.
    De Nicola L, Zoccali C (2016) Chronic kidney disease prevalence in the general population: heterogeneity and concerns. Nephrol Dial Transpl 31:331–335Google Scholar
  10. 10.
    Yoshino M, Kuhlmann MK, Kotanko P et al (2006) International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality. J Am Soc Nephrol 17:3510–3519Google Scholar
  11. 11.
    Estruch R, Ros E, Salas-Salvadó J, et al (2018) Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med 378:e34(1)–e34(14)Google Scholar
  12. 12.
    Huang X, Jiménez-Moleón JJ, Lindholm B et al (2013) Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrol 8:1548–1555Google Scholar
  13. 13.
    Sarnak MJ, Levey AS, Schoolwerth AC et al (2003) Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 108:2154–2169Google Scholar
  14. 14.
    Tonelli M, Muntner P, Lloyd A et al (2012) Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet 380:807–814Google Scholar
  15. 15.
    De Nicola L, Minutolo R, Chiodini P et al (2006) on behalf of the TArget Blood Pressure LEvels in Chronic Kidney Disease (TABLE in CKD) Study Group. Global approach to cardiovascular risk in chronic kidney disease: reality and opportunities for intervention. Kidney Int 69:538–545Google Scholar
  16. 16.
    De Nicola L, Chiodini P, Zoccali C et al, for the SIN-TABLE CKD Study Group (2011) Prognosis of CKD patients receiving outpatient nephrology care in Italy. Clin J Am Soc Nephrol 6:2421–2428Google Scholar
  17. 17.
    De Nicola L, Minutolo R, Chiodini P et al (2012) The effect of increasing age on the prognosis of non-dialysis patients with chronic kidney disease receiving stable nephrology care. Kidney Int 82:482–488Google Scholar
  18. 18.
    De Nicola L, Provenzano M, Chiodini P et al (2015) Independent role of underlying kidney disease on renal prognosis of patients with chronic kidney disease under nephrology care. PLoS One 10(5):e0127071Google Scholar
  19. 19.
    Khan SS, Kazmi WH, Abichandani R, Tighiouart H, Pereira BJ, Kausz AT (2002) Health care utilization among patients with chronic kidney disease. Kidney Int 62:229–236Google Scholar
  20. 20.
    Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305Google Scholar
  21. 21.
    Ishigami J, Grams ME, Chang AR et al (2017) CKD and risk for hospitalization with infection: the atherosclerosis risk in communities (ARIC) study. Am J Kidney Dis 69:752–761Google Scholar
  22. 22.
    Xie Y, Bowe B, Xian H, Balasubramanian S, Al-Aly Z (2015) Rate of kidney function decline and risk of hospitalizations in stage 3A CKD. Clin J Am Soc Nephrol 10:1946–1955Google Scholar
  23. 23.
    Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) KDIGO Clinical practice guideline for acute kidney injury. Kidney Int Suppl 2:1–138Google Scholar
  24. 24.
    James MT, Grams ME, Woodward M et al (2015) A Meta-analysis of the association of estimated GFR, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. Am J Kidney Dis 66:602–612Google Scholar
  25. 25.
    Nadkarni GN, Patel A, Simoes PK et al (2016) Dialysis-requiring acute kidney injury among hospitalized adults with documented hepatitis C Virus infection: a nationwide inpatient sample analysis. J Viral Hepat 23:32–38Google Scholar
  26. 26.
    Lopes JA, Fernandes J, Jorge S, Neves J, Antunes F, Prata MM (2007) Acute renal failure in critically ill HIV-infected patients. Crit Care 11:404Google Scholar
  27. 27.
    Franceschini N, Napravnik S, Finn WF, Szczech LA, Eron JJJ (2006) Immunosuppression, hepatitis C infection, and acute renal failure in HIV-infected patients. J Acquir Immune Defic Syndr 42:368–372Google Scholar
  28. 28.
    Wyatt C, Malvestutto C, Coca S, Klotman P, Parikh C (2008) The impact of hepatitis C virus co-infection on HIV-related kidney disease: a systematic review and meta-analysis. AIDS 22:1799–1807Google Scholar
  29. 29.
    Garg S, Hoenig M, Edwards E et al (2011) Incidence and predictors of acute kidney injury in an urban cohort of subjects with HIV and hepatitis C virus co-infection. AIDS Patient Care 25:135–141Google Scholar
  30. 30.
    Coca SG, Singanamala S, Parikh CR (2012) Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int 81:442–448Google Scholar
  31. 31.
    Bucaloiu ID, Kirchner HL, Norfolk ER, Hartle JE, Perkins RM (2012) Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury. Kidney Int 81:477–485Google Scholar
  32. 32.
    Minutolo R, Lapi F, Chiodini P et al (2014) Risk of ESRD and death in patients with CKD not referred to a nephrologist: a 7-year prospective study. Clin J Am Soc Nephrol 9:1586–1593Google Scholar
  33. 33.
    Chan MR, Dall AT, Fletcher KE et al (2007) Outcomes in patients with chronic kidney disease referred late to nephrologists: a meta-analysis. Am J Med 120:1063–1070Google Scholar
  34. 34.
    McLaughlin K, Manns B, Culleton B et al (2001) An economic evaluation of early versus late referral of patients with progressive renal insufficiency. Am J Kidney Dis 38:1122–1128Google Scholar
  35. 35.
    Zignego AL, Ramos-Casals M, Ferri C et al (2017) ISG-EHCV. International therapeutic guidelines for patients with HCV-related extrahepatic disorders. A multidisciplinary expert statement. Autoimmun Rev 16:523–541Google Scholar
  36. 36.
    Pasquariello A, Ferri C, Moriconi L, La Civita L, Longombardo G, Lombardini F, Greco F, Zignego AL (1993) Cryoglobulinemic membranoproliferative glomerulonephritis associated with hepatitis C virus. Am J Nephrol 13:300–304Google Scholar
  37. 37.
    McGuire BM, Julian BA, Bynon JS et al (2006) Brief communication: glomerulonephritis in patients with hepatitis C cirrhosis undergoing liver transplantation. Ann Intern Med 144:735–741Google Scholar
  38. 38.
    Fabrizi F, Plaisier E, Saadoun D, Martin P, Messa P, Cacoub P (2013) Hepatitis C virus infection, mixed cryoglobulinemia, and kidney disease. Am J Kidney Dis 61:623–637Google Scholar
  39. 39.
    Barsoum RS (2007) Hepatitis C virus: from entry to renal injury-facts and potentials. Nephrol Dial Transpl 22:1840–1848Google Scholar
  40. 40.
    Cacoub P, Poynard T, Ghillani P et al (1999) Extrahepatic manifestations of chronic hepatitis C. MULTIVIRC Group. Multidepartment Virus C Arthritis Rheum 42:2204–2212Google Scholar
  41. 41.
    Bukong TN, Momen-Heravi F, Kodys K, Bala S, Szabo G (2014) Exosomes from hepatitis C infected patients transmit HCV infection and contain replication competent viral RNA in complex with Ago2-miR122-HSP90. PLoS Pathog 10(10):e1004424Google Scholar
  42. 42.
    Rodríguez-Iñigo E, Casqueiro M, Bartolomé J et al (2000) Hepatitis C virus RNA in kidney biopsies from infected patients with renal diseases. J Viral Hepat 7:23–29Google Scholar
  43. 43.
    Sansonno D, Gesualdo L, Manno C, Schena FP, Dammacco F (1997) Hepatitis C virus-related proteins in kidney tissue from hepatitis C virus-infected patients with cryoglobulinemic membranoproliferative glomerulonephritis. Hepatology 25:1237–1244Google Scholar
  44. 44.
    Zignego AL, Gragnani L, Piluso A et al (2015) Virus-driven autoimmunity and lymphoproliferation: the example of HCV infection. Expert Rev Clin Immunol 11:15–31Google Scholar
  45. 45.
    Fornasieri A, D’Amico G (1996) Type II mixed cryoglobulinaemia, hepatitis C virus infection, and glomerulonephritis. Nephrol Dial Transpl 11(Suppl 4):25–30Google Scholar
  46. 46.
    Banas MC, Banas B, Hudkins KL et al (2008) TLR4 links podocytes with the innate immune system to mediate glomerular injury. J Am Soc Nephrol 19:704–713Google Scholar
  47. 47.
    Wörnle M, Schmid H, Banas B et al (2006) Novel role of toll-like receptor 3in hepatitis C-associated glomerulonephritis. Am J Pathol 168:370–385Google Scholar
  48. 48.
    Lai TS, Lee MH, Yang HI et al (2017) REVEAL-HCV Study Group Hepatitis C viral load, genotype, and increased risk of developing end-stage renal disease: REVEAL-HCV study. Hepatology 66:784–793Google Scholar
  49. 49.
    Kasuno K, Ono T, Matsumori A et al (2003) Hepatitis C virus-associated tubulointerstitial injury. Am J Kidney Dis 41:767–775Google Scholar
  50. 50.
    Bosman C, Valli MB, Bertolini L et al (1998) Detection of virus-like particles in liver biopsies from HCV-infected patients. Res Virol 149:311–314Google Scholar
  51. 51.
    Sabry A, E-Agroudy A, Sheashaa H et al (2005) HCV associated glomerulopathy in Egyptian patients: clinicopathological analysis. Virology 334:10–16Google Scholar
  52. 52.
    Johnson RJ, Gretch DR, Yamabe H et al (1993) Membranoproliferative glomerulonephritis associated with hepatitis C virus infection. N Engl J Med 328:465–470Google Scholar
  53. 53.
    Yamabe H, Johnson RJ, Gretch DR et al (1995) Hepatitis C virus infection and membranoproliferative glomerulonephritis in Japan. J Am Soc Nephrol 6:220–223Google Scholar
  54. 54.
    Fabrizi F, Lunghi G, Messa P, Martin P (2008) Therapy of hepatitis C virus-associated glomerulonephritis: current approaches. J Nephrol 21:813–825Google Scholar
  55. 55.
    Meyers CM, Seeff LB, Stehman-Breen CO, Hoofnagle JH (2003) Hepatitis C and renal disease: an update. Am J Kidney Dis 42:631–657Google Scholar
  56. 56.
    Beddhu S, Bastacky S, Johnson JP (2002) The clinical and morphologic spectrum of renal cryoglobulinemia. Med (Baltim) 81:398–409Google Scholar
  57. 57.
    Ferri C, Ramos-Casals M, Zignego AL et al (2016) International diagnostic guidelines for patients with HCV-related extrahepatic manifestations. A multidisciplinary expert statement. Autoimmun Rev 15:1145–1160Google Scholar
  58. 58.
    Arase Y, Ikeda K, Murashima N et al (1998) Glomerulonephritis in autopsy cases with hepatitis C virus infection. Intern Med 37:836–840Google Scholar
  59. 59.
    Altraif IH, Abdulla AS, al Sebayel MI, Said RA, al Suhaibani MO, Jones AA (1995) Hepatitis C associated glomerulonephritis. Am J Nephrol 15:407–410Google Scholar
  60. 60.
    Rollino C, Roccatello D, Giachino O, Basolo B, Piccoli G (1991) Hepatitis C virus infection and membranous glomerulonephritis. Nephron 59:319–320Google Scholar
  61. 61.
    Sperati CJ (2013) Stabilization of hepatitis C associated collapsing focal segmental glomerulosclerosis with interferon alpha- 2a and ribavirin. Clin Nephrol 80:231–234Google Scholar
  62. 62.
    Shah HH, Patel C (2013) Long-term response to peginterferon in hepatitis C virus-associated nephrotic syndrome from focal segmental glomerulosclerosis. Ren Fail 35:1182–1185Google Scholar
  63. 63.
    Ji F, Li Z, Ge H, Deng H (2010) Successful interferon-α treatment in a patient with IgA nephropathy associated with hepatitis C virus infection. Intern Med 49:2531–2532Google Scholar
  64. 64.
    Gonzalo A, Navarro J, Bárcena R, Quereda C, Ortuño J (1995) IgA nephropathy associated with hepatitis C virus infection. Nephron 69:354Google Scholar
  65. 65.
    Dey AK, Bhattacharya A, Majumdar A (2013) Hepatitis C as a potential cause of IgA nephropathy. Indian J Nephrol 23:143–145Google Scholar
  66. 66.
    Fogo A, Qureshi N, Horn RG (1993) Morphologic and clinical features of fibrillary glomerulonephritis versus immunotactoid glomerulopathy. Am J Kidney Dis 22:367–377Google Scholar
  67. 67.
    Coroneos E, Truong L, Olivero J (1997) Fibrillary glomerulonephritis associated with hepatitis C viral infection. Am J Kidney Dis 29:132–135Google Scholar
  68. 68.
    Guerra G, Narayan G, Rennke HG, Jaber BL (2003) Crescentic fibrillary glomerulonephritis associated with hepatitis C viral infection. Clin Nephrol 60:364–368Google Scholar
  69. 69.
    Brady HR (1998) Fibrillary glomerulopathy. Kidney Int 53:1421–1429Google Scholar
  70. 70.
    Philipneri M, Bastani B (2001) Kidney disease in patients with chronic hepatitis C. Curr Gastroenterol Rep 3:79–83Google Scholar
  71. 71.
    Martin P, Fabrizi F (2008) Hepatitis C virus and kidney disease. J Hepatol 49:613–624Google Scholar
  72. 72.
    Hestin D, Guillemin F, Castin N, Le Faou A, Champigneulles J, Kessler M (1998) Pretransplant hepatitis C virus infection: a predictor of proteinuria after renal transplantation. Transplantation 65:741–744Google Scholar
  73. 73.
    Cosio FG, Roche Z, Agarwal A, Falkenhain ME, Sedmak DD, Ferguson RM (1996) Prevalence of hepatitis C in patients with idiopathic glomerulopathies in native and transplant kidneys. Am J Kidney Dis 28:752–758Google Scholar
  74. 74.
    Mathurin P, Mouquet C, Poynard T et al (1999) Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology 29:257–263Google Scholar
  75. 75.
    Roth D, Cirocco R, Zucker K et al (1995) De novo membranoproliferative glomerulonephritis in hepatitis C virus-infectedrenal allograft recipients. Transplantation 59:1676–1682Google Scholar
  76. 76.
    Mahmoud I, Sobh M, El-Habashi A et al (2005) Interferon therapy in haemodialysis patients with chronic hepatitis C: study of tolerance, efficacy and post-transplantation course. Nephron Clin Pract 100:c133–c139Google Scholar
  77. 77.
    Morales JM, Pascual-Capdevila J, Campistol JM et al (1997) Membranous glomerulonephritis associated with hepatitis C virus infection in renal transplant patients. Transplantation 63:1634–1639Google Scholar
  78. 78.
    Bergman S, Accortt N, Turner A, Glaze J (2005) Hepatitis C infection is acquired pre-ESRD. Am J Kidney Dis 45:684–689Google Scholar
  79. 79.
    Rogal S, Yan P, Rimland D et al (2016) Electronically retrieved cohort of HCV infected veterans study group. Incidence and progression of chronic kidney disease after hepatitis C seroconversion: results from ERCHIVES. Dig Dis Sci 61:930–936Google Scholar
  80. 80.
    Fabrizi F, Donato FM, Messa P (2018) Association between hepatitis C virus and chronic kidney disease: a systematic review and meta-analysis. Ann Hepatol 17:364–391Google Scholar
  81. 81.
    Fabrizi F, Lunghi G, Finazzi S et al (2001) Decreased serum aminotransferase activity in patients with chronic renal failure: impact on the detection of viral hepatitis. Am J Kidney Dis 38:1009–1015Google Scholar
  82. 82.
    Espinosa M, Martin-Malo A, Alvarez de Lara M, Soriano S, Aljama P (2000) High ALT levels predict viremia in anti-HCV positive HD patients if a modified normal range of ALT is applied. Clin Nephrol 54:151–156Google Scholar
  83. 83.
    Li H, Lo S (2015) Hepatitis C virus: virology, diagnosis and treatment. World J Hepatol 7:1377–1389Google Scholar
  84. 84.
    Colin C, Lanoir D, Touzet S, Meyaud-Kraemer L, Bailly F, Trepo C (2001) Sensitivity and specificity of third-generation hepatitis C virus antibody detection assays: an analysis of the literature. J Viral Hepat 8:87–95Google Scholar
  85. 85.
    Schneeberger P, Keur I, van der Vliet W et al (1998) Hepatitis C virus infection in dialysis centers in The Netherlands: a national survey by serological and molecular methods. J Clin Microbiol 36:1711–1715Google Scholar
  86. 86.
    Barrera J, Francis B, Ercilla G et al (1995) Improved detection of anti-HCV in post-transfusion hepatitis by a third-generation ELISA. Vox Sang 68:15–18Google Scholar
  87. 87.
    El-Sherif A, Elbahrawy A, Aboelfotoh A et al (2012) High false-negative rate of anti-HCV among Egyptian patients on regular haemodialysis. Hemodial Int 16:420–427Google Scholar
  88. 88.
    Kidney Disease (2008) Improving Global Outcomes. KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of Hepatitis C in chronic kidney disease. Kidney Int 73(Suppl 109):S1–S99Google Scholar
  89. 89.
    European Association for the Study of the Liver (2018) EASL recommendations on treatment of hepatitis C 2018. J Hepatol 69:461–511Google Scholar
  90. 90.
    Furusyo N, Hayashi J, Ariyama I et al (2000) Maintenance hemodialysis decreases serum hepatitis C virus (HCV) RNA levels in haemodialysis patients with chronic HCV infection. Am J Gastroenterol 95:490–496Google Scholar
  91. 91.
    Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST (2013) Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology 57:1333–1342Google Scholar
  92. 92.
    Crook E, Penumalee S, Gavini B, Filippova K (2005) Hepatitis C is a predictor of poorer renal survival in diabetic patients. Diabetes Care 28:2187–2191Google Scholar
  93. 93.
    Noureddine L, Usman S, Yu Z, Moorthi R, Moe S (2010) Hepatitis C increases the risk of progression of chronic kidney disease in patients with glomerulonephritis. Am J Nephrol 32:311–316Google Scholar
  94. 94.
    Fabrizi F, Dixit V, Martin P, Messa P (2016) Hepatitis C virus increases the risk of kidney disease among HIV-positive patients: systematic review and meta-analysis. J Med Virol 88:487–497Google Scholar
  95. 95.
    Lai T, Lee M, Yang H et al (2017) High hepatitis C viral load and genotype 2 are strong predictors of chronic kidney disease. Kidney Int 92:703–709Google Scholar
  96. 96.
    Blè M, Aguilera V, Rubin A et al (2014) Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease. Liver Transpl 20:25–34Google Scholar
  97. 97.
    Arase Y, Suzuki F, Kawamura Y et al (2011) Development rate of chronic kidney disease in hepatitis C virus patients with advanced fibrosis after interferon therapy. Hepatol Res 41:946–954Google Scholar
  98. 98.
    Hsu Y, Lin J, Ho H et al (2014) Antiviral treatment for hepatitis C virus infection is associated with improved renal and cardiovascular outcomes in diabetic patients. Hepatology 59:1293–1302Google Scholar
  99. 99.
    Hsu Y, Ho H, Huang Y et al (2015) Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection. Gut 64:495–503Google Scholar
  100. 100.
    Chen Y, Hwang S, Li C, Wu C, Lin L (2015) A Taiwanese nationwide cohort study shows interferon-based therapy for chronic hepatitis C reduces the risk of chronic kidney disease. Med (Baltim) 94:e1334Google Scholar
  101. 101.
    Aoufi SR, García RA, Tenías Burillo JM et al (2012) Microalbuminuria and renal insufficiency in chronic hepatitis C virus infection. Gastroenterol Hepatol 35:309–316Google Scholar
  102. 102.
    Leone S, Prosperi M, Costarelli S et al (2016) Incidence and predictors of cardiovascular disease, chronic kidney disease, and diabetes in HIV/HCV-coinfected patients who achieved sustained virological response. Eur J Clin Microbiol Infect Dis 35:1511–1520Google Scholar
  103. 103.
    Boddi M, Abbate R, Chellini B et al (2010) Hepatitis C virus RNA localization in human carotid plaque. J Clin Virol 47:72–75Google Scholar
  104. 104.
    Adinolfi L, Zampino R, Restivo L et al (2014) Chronic hepatitis C virus infection and atherosclerosis: clinical impact and mechanisms. World J Gastroenterol 20:3410–3417Google Scholar
  105. 105.
    Molnar M, Alhourani H, Wall B et al (2015) Association of hepatitis C virus infection with incidence and progression of chronic kidney disease in a large cohort of US veterans. Hepatology 61:1495–1502Google Scholar
  106. 106.
    Sabovic M, Salobir B, Preloznik Zupan I et al (2005) The influence of the haemodialysis procedure on platelets, coagulation and fibrinolysis. Pathophysiol Haemost Thromb 34:274–278Google Scholar
  107. 107.
    Manno C, Bonifati C, Torres D, Campobasso N, Schena F (2011) Desmopressin acetate in percutaneous ultrasound-guided kidney biopsy: a randomized controlled trial. Am J Kidney Dis 57:850–855Google Scholar
  108. 108.
    Schiavon LL, Schiavon JL, Filho RJ et al (2007) Simple blood tests as noninvasive markers of liver fibrosis in hemodialysis patients with chronic hepatitis C virus infection. Hepatology 46:307–314Google Scholar
  109. 109.
    Liu CH, Liang CC, Huang KW et al (2011) Transient elastography to assess hepatic fibrosis in hemodialysis chronic hepatitis C patients. Clin J Am Soc Nephrol 6:1057–1065Google Scholar
  110. 110.
    Canbakan M, Senturk H, Canbakan B et al (2011) Validation of biochemical markers for the prediction of liver fibrosis and necroinflammatory activity in hemodialysis patients with chronic hepatitis C. Nephron Clin Pract 117:c289–295Google Scholar
  111. 111.
    D’Amico G, Morabito A, D’Amico M et al (2017) New concepts on the clinical course and stratification of compensated and decompensated cirrhosis. Hepatol Int 12(Suppl 1):34–43Google Scholar
  112. 112.
    Alashek W, McIntyre C, Taal M (2012) Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors. BMC Infect Dis 12:265Google Scholar
  113. 113.
    Garcia-Agudo R, Aoufi-Rabih S, Barril-Cuadrado G (2013) Grupo de Virus en Dialisis de la Sociedad Espanola de Nefrologia. SHECTS multi-centre Spanish Study: liver situation of patients with chronic hepatitis from HCV on renal replacement therapy with haemodialysis. Nefrologia 33:188–195Google Scholar
  114. 114.
    Goodkin D, Bieber B, Gillespie B, Robinson B, Jadoul M (2013) Hepatitis C infection is very rarely treated among haemodialysis patients. Am J Nephrol 38:405–412Google Scholar
  115. 115.
    Ummate I, Denue B, Kida I, Ohioma O, Baba D, Goni W (2014) Risk factors for hepatitis C virus seropositivity among haemodialysis patients receiving care at kidney centre in a tertiary health facility in Maiduguri, Nigeria. Pan Afr Med J 19:305Google Scholar
  116. 116.
    Lioussfi Z, Errami Z, Radoui A et al (2014) Viral hepatitis C and B among dialysis patients at the Rabat University Hospital: prevalence and risk factors. Saudi J Kidney Dis Transpl 25:672–679Google Scholar
  117. 117.
    Vidales-Braz B, da Silva N, Lobato R et al (2015) Detection of hepatitis C virus in patients with terminal renal disease undergoing dialysis in southern Brazil: prevalence, risk factors, genotypes, and viral load dynamics in haemodialysis patients. Virol J 12:8Google Scholar
  118. 118.
    Duong C, Olszyna D, McLaws M (2015) Hepatitis B and C virus infections among patients with end stage renal disease in a low-resourced hemodialysis center in Vietnam: a cross-sectional study. BMC Public Health 15:192Google Scholar
  119. 119.
    Malhotra R, Soin D, Grover P, Galhotra S, Khutan H, Kaur N (2016) Hepatitis B virus and hepatitis C virus co-infection in haemodialysis patients: a retrospective study from a tertiary care hospital of North India. J Nat Sci Biol Med 7:72–74Google Scholar
  120. 120.
    Fabrizi F, Messa P (2015) Transmission of hepatitis C virus in dialysis units: a systematic review of reports on outbreaks. Int J Artif Organs 38:471–480Google Scholar
  121. 121.
    Thompson N, Perz J, Moorman A, Holmberg S (2009) Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998–2008. Ann Intern Med 150:33–39Google Scholar
  122. 122.
    Centers for Disease Control. Hepatitis: control measures for hepatitis B in dialysis centers. Altlanta, GA: US Department of Health, Education and Welfare; 1977. HEW publication no. (CDC) 78-8358Google Scholar
  123. 123.
    Centers for Disease Control and Prevention (2001) Recommendations for preventing transmission of infections among chronic haemodialysis patients. MMWR Morb Mortal Wkly Rep 50:1–43Google Scholar
  124. 124.
    Centers for Disease Control and Prevention (2008) Infection control requirements for dialysis facilities and clarification regarding guidance on parenteral medication vials. MMWR Morb Mortal Wkly Rep 57:875–876Google Scholar
  125. 125.
    Patel P, Yi S, Booth S et al (2013) Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort in a quality improvement report. Am J Kidney Dis 62:322–330Google Scholar
  126. 126.
    Arenas M, Sanchez-Paya J et al (2005) A multicentric survey of the practice of hand hygiene in haemodialysis units: factors affecting compliance. Nephrol Dial Transpl 20:1164–1171Google Scholar
  127. 127.
    Jadoul M, Poignet J, Geddes C et al (2004) The changing epidemiology of hepatitis C virus infection in haemodialysis: European multicentre study. Nephrol Dial Transpl 19:904–909Google Scholar
  128. 128.
    Senatore S, Galli C, Conti A et al (2016) Hepatitis C virus outbreak in a haemodialysis unit: learning from failures. J Hosp Infect 94:249–252Google Scholar
  129. 129.
    Muleta D, Kainer M, Moore-Moravian L et al (2016) Notes from the field: hepatitis C outbreak in a dialysis clinic—Tennessee, 2014. MMWR Morb Mortal Wkly Rep 64:1386–1387Google Scholar
  130. 130.
    Nguyen D, Gutowoski J, Ghiselli M et al (2016) A large outbreak of hepatitis C virus infections in a haemodialysis clinic. Infect Control Hosp Epidemiol 37:125–133Google Scholar
  131. 131.
    Centers for Disease Control and Prevention (2017) Healthcare-associated hepatitis B and C outbreaks (≥ 2 cases) reported to the Centers for Disease Control and Prevention (CDC) 2008–2016. Accessed 4 Aug 2017
  132. 132.
    Centers for Disease Control and Prevention (2016) CDC urging dialysis providers and facilities to assess and improve infection control practices to stop hepatitis C virus transmission in patients undergoing haemodialysis. Am J Transpl 16:1633–1634Google Scholar
  133. 133.
    Shimokura G, Chai F, Weber D et al (2011) Patient-care practices associated with an increased prevalence of hepatitis C virus infection among chronic haemodialysis patients. Infect Control Hosp Epidemiol 32:415–424Google Scholar
  134. 134.
    Bravo Zuniga J, Loza Munarriz C, Lopez-Alcalde J (2016) Isolation as a strategy for controlling the transmission of hepatitis C virus (HCV) infection in haemodialysis units. Cochrane Database Syst Rev 8:CD006420Google Scholar
  135. 135.
    Shamshirsaz A, Kamgar M, Bekheirnia M et al (2004) The role of haemodialysis machines dedication in reducing hepatitis C transmission in the dialysis setting in Iran: a multicentre prospective interventional study. BMC Nephrol 5:13Google Scholar
  136. 136.
    Fissell R, Bragg-Gresham J, Woods J et al (2004) Patterns of hepatitis C prevalence and seroconversion in haemodialysis units from three continents: the DOPPS. Kidney Int 65:2335–2342Google Scholar
  137. 137.
    Di Napoli A, Pezzotti P, Di Lallo D et al (2006) Epidemiology of hepatitis C virus among long-term dialysis patients: a 9-year study in an Italian region. Am J Kidney Dis 48:629–637Google Scholar
  138. 138.
    Jadoul M, Cornu C, van Ypersele de Strihou C (1998) Universal precautions prevent hepatitis C virus transmission: a 54 month follow-up of the Belgian Multicenter Study. The Universitaires Cliniques St-Luc (UCL) Collaborative Group. Kidney Int 53:1022–1025Google Scholar
  139. 139.
    Gilli P, Soffritti S, De Paoli Vitali E, Bedani P (1995) Prevention of hepatitis C virus in dialysis units. Nephron 70:301–306Google Scholar
  140. 140.
    Sampietro M, Graziani G, Badalamenti S et al (1994) Detection of hepatitis C virus in dialysate and in blood ultrafiltrate of HCV-positive patients. Nephron 68:140Google Scholar
  141. 141.
    Kaiser T, Damerow HC, Tenckhoff S et al (2008) Kinetics of hepatitis C viral RNA and HCV-antigen during dialysis sessions: evidence for differential viral load reduction on dialysis. J Med Virol 80:1195–1201Google Scholar
  142. 142.
    Fabrizi F, Martin P, Dixit V et al (2000) Biological dynamics of viral load in hemodialysis patients with hepatitis C virus. Am J Kidney Dis 35:122–129Google Scholar
  143. 143.
    Fabrizi F, Martin P, Dixit V et al (1998) Acquisition of hepatitis C virus in hemodialysis patients: a prospective study by branched DNA signal amplification assay. Am J Kidney Dis 31:647–654Google Scholar
  144. 144.
    Saab S, Martin P, Brezina M, Gitnick G, Yee H (2001) Serum alanine aminotransferase in hepatitis C screening of patients on haemodialysis. Am J Kidney Dis 37:308–315Google Scholar
  145. 145.
    Aghemo A, De Francesco R (2013) New horizons in hepatitis C antiviral therapy with direct-acting antivirals. Hepatology 58:428–438Google Scholar
  146. 146.
    Pawlotsky JM (2014) New hepatitis C therapies: the toolbox, strategies, and challenges. Gastroenterology 146:1176–1192Google Scholar
  147. 147.
    D’Ambrosio R, Degasperi E, Colombo M, Aghemo A (2017) Direct-acting antivirals: the endgame for hepatitis C? Curr Opin Virol 24:31–37Google Scholar
  148. 148.
    Aoufi-Rabih S, García-Agudo R, Londoño MC, Fraga-Fuentes MD, Barril-Cuadrado (2018) G on behalf on the Spanish Association of the Liver and the Kidney (AEHR). Recommendations for the treatment of hepatitis C virus infection in chronic kidney disease. J Nephrol 31:1–13Google Scholar
  149. 149.
    Hubbard H, Lawitz E (2018) Glecaprevir + pibrentasvir (ABT493 + ABT-530) for the treatment of Hepatitis C. Expert Rev Gastroenterol Hepatol 12:9–17Google Scholar
  150. 150.
    Pockros PJ, Reddy KR, Mantry PS et al (2016) Efficacy of Direct-acting antiviral combination for patients with hepatitis C virus genotype 1 infection and severe renal impairment or end-stage renal disease. Gastroenterology 150:1590–1598Google Scholar
  151. 151.
    Roth D, Nelson DR, Bruchfeld A et al (2015) Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4–5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet 386:1537–1545Google Scholar
  152. 152.
    Gane E, Lawitz E, Pugatch D et al (2017) Glecaprevir and pibrentasvir in patients with HCV and severe renal impairment. N Engl J Med 377:1448–1455Google Scholar
  153. 153.
    De Nicola S, Aghemo A (2016) The quest for safe and effective treatments of chronic hepatitis C in patients with kidney impairment. Liver Int 36:791–793Google Scholar
  154. 154.
    Saxena V, Khungar V, Verna EC et al (2017) Safety and efficacy of current direct-acting antiviral regimens in kidney and liver transplant recipients with hepatitis C: results from the HCV-TARGET study. Hepatology 66:1090–1101Google Scholar
  155. 155.
    Saxena V, Koraishy FM, Sise ME et al (2016) Safety and efficacy of sofosbuvir-containing regimens in hepatitis C-infected patients with impaired renal function. Liver Int 36:807–816Google Scholar
  156. 156.
    Li T, Qu Y, Guo Y, Wang Y, Wang L (2017) Efficacy and safety of direct-acting antivirals-based antiviral therapies for hepatitis C virus patients with stage 4–5 chronic kidney disease: a meta-analysis. Liver Int 37:974–981Google Scholar
  157. 157.
    Fissell RB, Bragg-Gresham JL et al (2004) Patterns of hepatitis C prevalence and seroconversion in hemodialysis units from three continents: the DOPPS. Kidney Int 65:2335–2342Google Scholar
  158. 158.
    Ingsathit A, Kamanamool N, Thakkinstian A, Sumethkul V (2013) Survival advantage of kidney transplantation over dialysis in patients with hepatitis C: a systematic review and meta-analysis. Transplantation 95:943–948Google Scholar
  159. 159.
    Cueto-Manzano AM, Morales-Buenrostro LE, González-Espinoza L et al (2005) Markers of inflammation before and after renal transplantation. Transplantation 80:47–51Google Scholar
  160. 160.
    Paoletti E, Bellino D, Signori A et al (2016) Regression of asymptomatic cardiomyopathy and clinical outcome of renal transplant recipients: a long-term prospective cohort study. Nephrol Dial Transpl 31:1168–1174Google Scholar
  161. 161.
    Roth D, Gaynor JJ, Reddy KR et al (2011) Effect of kidney transplantation on outcomes among patients with hepatitis C. J Am Soc Nephrol 22:1152–1160Google Scholar
  162. 162.
    Fabrizi F, Martin P, Dixit V, Messa P (2014) Meta-analysis of observational studies: hepatitis C and survival after renal transplant. J Viral Hepat 21:314–324Google Scholar
  163. 163.
    Heo NY, Mannalithara A, Kim D et al (2018) Long-term patient and graft survival of kidney transplant recipients with hepatitis C virus infection in the United States. Transplantation 102:454–460Google Scholar
  164. 164.
    Morales JM, Fabrizi F (2015) Hepatitis C and its impact on renal transplantation. Nat Rev Nephrol 11:172–182Google Scholar
  165. 165.
    Fabrizi F, Aghemo A, Messa P (2013) Hepatitis C treatment in patients with kidney disease. Kidney Int 84:874–879Google Scholar
  166. 166.
    Rendina M, Schena A, Castellaneta NM et al (2007) The treatment of chronic hepatitis C with peginterferon alfa-2a (40 kDa) plus ribavirin in haemodialysed patients awaiting renal transplant. J Hepatol 46:768–774Google Scholar
  167. 167.
    Kamar N, Marion O, Rostaing L et al (2016) Efficacy and safety of sofosbuvir-based antiviral therapy to treat Hepatitis C Virus Infection after kidney transplantation. Am J Transpl 16:1474–1479Google Scholar
  168. 168.
    Sawinski D, Kaur N, Ajeti A et al (2016) Successful treatment of hepatitis C in renal transplant recipients with direct-acting antiviral agents. Am J Transpl 16:1588–1595Google Scholar
  169. 169.
    Lin MV, Sise ME, Pavlakis M et al (2016) Efficacy and safety of direct acting antivirals in kidney transplant recipients with chronic Hepatitis C Virus Infection. PLoS One 11(7):e0158978Google Scholar
  170. 170.
    Beinhardt S, Al Zoairy R, Ferenci P et al (2016) DAA-based antiviral treatment of patients with chronic hepatitis C in the pre- and postkidney transplantation setting. Transpl Int 29:999–1007Google Scholar
  171. 171.
    Lubetzky M, Chun S, Joelson A et al (2017) Safety and efficacy of treatment of hepatitis C in kidney transplant recipients with directly acting antiviral agents. Transplantation 101:1704–1710Google Scholar
  172. 172.
    Colombo M, Aghemo A, Liu H et al (2017) Treatment with ledipasvir-sofosbuvir for 12 or 24 weeks in kidney transplant recipients with chronic hepatitis C virus genotype 1 or 4 infection: a randomized trial. Ann Intern Med 166:109–117Google Scholar
  173. 173.
    Morales AL, Liriano-Ward L et al (2017) Ledipasvir/sofosbuvir is effective and well tolerated in postkidney transplant patients with chronic hepatitis C virus. Clin Transpl 31(5):e12941. Google Scholar
  174. 174.
    Reau N, Kwo PY, Rhee S et al (2017) MAGELLAN-2: safety and efficacy of glecaprevir/pibrentasvir in liver or renal transplant adults with chronic hepatitis C genotype 1–6 infection. J Hepatol 66(Suppl.1):S90–S91Google Scholar
  175. 175.
    Fernández I, Muñoz-Gómez R, Pascasio JM et al (2017) Efficacy and tolerability of interferon-free antiviral therapy in kidney transplant recipients with chronic hepatitis C. J Hepatol 66:718–723Google Scholar
  176. 176.
    Fernández-Ruiz M, Polanco N, García-Santiago A et al (2018) Impact of anti-HCV direct antiviral agents on graft function and immunosuppressive drug levels in kidney transplant recipients: a call to attention in the mid-term follow-up. Transpl Int 31:887–899Google Scholar
  177. 177.
    Smolders EJ, de Kanter CT, van Hoek B, Arends JE, Drenth JP, Burger DM (2016) Pharmacokinetics, efficacy, and safety of hepatitis C virus drugs in patients with liver and/or renal impairment. Drug Saf 39:589–611Google Scholar
  178. 178.
    Rendina M, Castellaneta NM, Losurdo G et al (2018) Primary biliary cirrosis by DAAs-induced HCV clearance: a biological proof of concept. Ther Adv Chronic Dis 9:121–123Google Scholar
  179. 179.
    La Manna G (2018) HCV and kidney transplant in the era of new direct-acting antiviral agents (DAAs). J Nephrol 31(2):185–187Google Scholar
  180. 180.
    Kucirka LM, Peters TG, Segev DL (2012) Impact of donor hepatitis C virus infection status on death and need for liver transplant in hepatitis C virus-positive kidney transplant recipients. Am J Kidney Dis 60:112–120Google Scholar
  181. 181.
    Scalea JR, Barth RN, Munivenkatappa R, Philosophe B, Cooper M, Whitlow V, LaMattina JC (2015) Shorter waitlist times and improved graft survivals are observed in patients who accept hepatitis C virus + renal allografts. Transplantation 99:1192–1196Google Scholar
  182. 182.
    McCauley M, Mussell A, Goldberg D et al (2018) Race, risk, and willingness of end-stage renal disease patients without hepatitis C (HCV) to accept an HCV-infected kidney transplant. Transplantation 102:e163–e170Google Scholar
  183. 183.
    Sawinski D, Wyatt CM, Locke JE (2017) Expanding the use of hepatitis C-viremic kidney donors. Kidney Int 92:1031–1033Google Scholar
  184. 184.
    Bhamidimarri KR, Ladino M, Pedraza F et al (2017) Transplantation of kidneys from hepatitis C-positive donors into hepatitis C virus-infected recipients followed by early initiation of direct acting antiviral therapy: a single-center retrospective study. Transpl Int 30:865–873Google Scholar
  185. 185.
    Goldberg DS, Abt PL, Reese PP (2017) THINKER Trial Investigators. Transplanting HCV-infected kidneys into uninfected recipients. N Engl J Med 377:1105Google Scholar
  186. 186.
    Janssen Therapeutics (2017) Olysio prescribing information 2017. Janssen Therapeutics, TitusvilleGoogle Scholar
  187. 187.
    Forns X, Berenguer M, Herzer K et al (2017) Efficacy, safety, and pharmacokinetics of simeprevir, daclatasvir, and ribavirin in patients with recurrent hepatitis C virus genotype 1b infection after orthotopic liver transplantation: the Phase II SATURN study. Transpl Infect Dis 19(3):e12696. Google Scholar
  188. 188.
    Ouwerkerk-Mahadevan S, Snoeys J, Peeters M, Beumont-Mauviel M, Simion A (2016) Drug–drug interactions with the NS3/4A protease inhibitor simeprevir. Clin Pharmacokinet 55:197–208Google Scholar
  189. 189.
    Mogalian E, German P, Kearney BP et al (2016) Use of multiple probes to assess transporter- and cytochrome P450-mediated drug-drug interaction potential of the pangenotypic hcv ns5a inhibitor velpatasvir. Clin Pharmacokinet 55:605–613Google Scholar
  190. 190.
  191. 191.
  192. 192.

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Roberto Minutolo
    • 1
    Email author
  • Alessio Aghemo
    • 2
    • 3
  • Antonio Chirianni
    • 4
  • Fabrizio Fabrizi
    • 5
  • Loreto Gesualdo
    • 6
  • Edoardo G. Giannini
    • 7
  • Paolo Maggi
    • 8
  • Vincenzo Montinaro
    • 6
  • Ernesto Paoletti
    • 9
  • Marcello Persico
    • 10
  • Francesco Perticone
    • 11
  • Salvatore Petta
    • 12
  • Massimo Puoti
    • 13
  • Giovanni Raimondo
    • 14
  • Maria Rendina
    • 15
  • Anna Linda Zignego
    • 16
  • on behalf of the Italian Society of Nephrology (SIN)
  • the Italian Association for the Study of the Liver (AISF)
  • the Italian Society of Infectious and Tropical Disease (SIMIT)
  • the Italian Society of Internal Medicine (SIMI)
  1. 1.Division of Nephrology, Department of Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell’InvecchiamentoUniversity of Campania “Luigi Vanvitelli”NaplesItaly
  2. 2.Department of Biomedical SciencesHumanitas UniversityMilanItaly
  3. 3.Division of Internal Medicine and HepatologyHumanitas Clinical and Research CenterMilanItaly
  4. 4.Third Department of Infectious Diseases Azienda Ospedaliera Ospedali dei ColliNaplesItaly
  5. 5.Division of NephrologyMaggiore Hospital and IRCCS FoundationMilanItaly
  6. 6.Division of NephrologyAzienda Ospedaliero-Universitaria Policlinico di BariBariItaly
  7. 7.Gastroenterology Unit, Department of Internal MedicineUniversity of GenoaGenoaItaly
  8. 8.Infectious Disease ClinicUniversity of BariBariItaly
  9. 9.Nephrology, Dialysis, and Transplantation, University of Genoa and Policlinico San MartinoGenoaItaly
  10. 10.Internal Medicine and Hepatology UnitAOU San Giovanni di Dio e Ruggi d’AragonaSalernoItaly
  11. 11.Department of Medical and Surgical SciencesUniversity Magna GræciaCatanzaroItaly
  12. 12.Gastroenterology and Hepatology UnitDi.Bi.M.I.S., University of PalermoPalermoItaly
  13. 13.Division of Infectious DiseasesNiguarda Cà Granda HospitalMilanItaly
  14. 14.Department of Medicina Clinica e SperimentaleUniversity of MessinaMessinaItaly
  15. 15.Department of Emergency and Organ Transplantation, Section of GastroenterologyUniversity HospitalBariItaly
  16. 16.Department of Experimental and Clinical Medicine, Interdepartmental Hepatology Center MaSVEUniversity of FlorenceFlorenceItaly

Personalised recommendations