The present study reports prevalence of posttransplant hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in 256 patients with chronic renal failure (CRF) and with a history of either renal transplant or hemodialysis. Out of 256 patients 138 had renal transplant and 118 were on maintenance hemodialysis. Among the patients screened, 7% had HBV infection alone, 46% were infected with HCV alone, while 37.10% were found to have co-infection of both the viruses. Our findings implicate these viruses as the major cause of posttransplant hepatitis in Indian patients with CRF and indicate implementation of stringent screening procedures for these two viral infections.

to determine the number needed to vaccinate (NNV) to prevent mortality from HAV. The total vaccine cost was also calculated. Baseline mortality and cost data from the US were used as an example. Results 239 studies were identified using a defined search strategy. From those, 11 appeared to be relevant to the study and of these 7 were suitable for inclusion in the meta-analysis. The pooled OR for mortality risk in HAV superinfection of HCV infected persons was 7.23 (95% CI 1.24 to 42.12) with significant heterogeneity (I 2 ¼56%, p¼0.03) between studies. Case-fatality rates are however low, and in the US at the last estimate (2007) the number of deaths from HAV in the general population was 34 per year (0.2/1 000 000 population). Using the pooled OR for mortality that translates to 1.4 deaths per 1 000 000 susceptible persons with HCV per year. The NNV to prevent 1 death per year is therefore 814 849 assuming 90% vaccine uptake and 94.3% vaccine efficiency. The vaccine cost for this totals $162 million, or $80.1 million per death prevented per year. Conclusion These data challenge the utility of routine HAV vaccination in HCV infected persons and its incorporation into clinical practice guidelines. HAV vaccination of all HCV infected persons in low incidence areas is likely to expose many individuals to an intervention that is of no direct benefit.Competing interests None declared. Introduction Pegylated interferon (Peg-IFN) therapy responses in chronic hepatitis B (CH-B) are associated with decline of HBsAg plasma levels (qHBsAg) (>10% in HBeAgÀ and >0.5 log 10 IU/ml in HBeAg+) and HBV DNA decrease >2 log 10 IU/ml during the first 6 months of therapy. In contrast, qHBsAg decline is less pronounced, but with sharper HBV DNA decline on therapy with nucleos(t)ide analogues (NA). The previous studies comparing qHBsAg and HBV DNA kinetics between Peg-IFN and NA treatments were performed on variable cohorts, but not on a monocentric single cohort of patients undergoing consecutively variable courses of therapy. Aims To compare the kinetics of qHBsAg and HBV DNA levels before and during therapy; initially with Peg-IFN and then after at least a 6-month break (median 15 months) with subsequent NA therapy in the same cohort of CH-B patients. Methods qHBsAg levels by Abbott ARCHITECTÒ assay and HBV DNA by real-time TaqMan PCR [both log 10 IU/ml] were quantified in serial samples at baseline, treatment week 12 (TW12), TW24, TW48. HBeAg loss/anti-HBe seroconversion were evaluated at the same time-points. All results are presented as medians. Results Four Peg-IFN patients (20%) achieved anti-HBe seroconversion, in contrast to only 1 NA patient (5%). At baseline, qHBsAg and HBV DNA levels were similar between . At TW12 and TW24, qHBsAg did not change in , but HBV DNA dropped significantly during NA therapy only (4.55 vs 2.29 and 4.53 vs 1.23, both p<0.01). At TW48, qHBsAg remained unchanged in both treatments (3.48 vs 3.46), but HBV DNA was undetectable in NA patients (0 vs 4.68, p<0.01). Only NA therapy achieved complete virol...

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