Diagnosis and evaluation of hepatitis C virus among haemodialysis patients

Bahadi, Abdelali; Maoujoud, Omar; Zejjari, Y; Alayoud, Ahmed; Hassani, Kawtar; Elkabbaj, Driss; Benyahia, Mohamed

doi:10.26719/2013.19.2.192

Cited by 6 publications

(7 citation statements)

References 14 publications

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“…Considering the lack of data on some epidemiological parameters such as mortality rate and utility scores in Moroccan hemodialysis patients, we based our analysis on results of randomized controlled trials and systematic reviews that have been conducted on this topic; to limit this potential bias. Also, our baseline estimates of hospitalizations rates and duration are based on some Moroccan retrospectives studies, 15,16,24,[29][30][31] for this reason, we have also consider the results of previous cohort studies and analysis conducted in other countries. We did not include indirect costs such as loss of productivity and travel costs.…”

Section: Figurementioning

confidence: 99%

“…Transfusion requirement for patients not receiving ESAs was based on two Moroccan studies (Benamar et al 15 and Bahadi et al 16 ), also we considered for our analysis the data reported by Remak et al 4 and Naci et al, 17 according to those studies; the average number of RBCT/year needed was estimated in our model at 10 red blood cell units/year.…”

Section: Rbct Requirementmentioning

confidence: 99%

“…[29][30][31][32] In the absence of RCT investigating the relationship between ESA use or Hb level, and the risk or the duration of hospitalization, we assumed in our model that there is no difference in hospital stay for the three Hb ranges, this assumption is comforted by previous studies. 17,20,33 Hospitalizations in patients receiving RBCT only in the model were based on Moroccan observational data reported by Bahadi et al, 16 and the studies of Remak et al 4 and Naci et al; 17 considering those reports, ESA use in CHP is associated with a decrease in hospitalization estimated at −37% in comparison with patients receiving RBCT. Baseline clinical, costs and assumptions are reported in Table 1.…”

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confidence: 99%

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The cost-utility of treating anemia with continuous erythropoietin receptor activator or Epoetin versus routine blood transfusions among chronic hemodialysis patients

Maoujoud

Ahid

Cherrah

2016

IJNRD

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Objective: The purpose of this study was to determine the cost-utility of treating anemic dialysis patients with continuous erythropoietin receptor activator (CERA) once monthly or Epoetin Beta (EpoB) thrice weekly compared with a reference strategy of managing anemia with red blood cell transfusion (RBCT). Methods: Cost-utility analysis study design. Decision analysis model, National health care payer, over 1 year with the publicly funded health care system. Chronic hemodialysis patients with renal anemia were included. The outcome marker of this study was the incremental cost per quality-adjusted life-year (QALY) gained (incremental cost-utility ratio [ICUR]) of CERA or EpoB relative to RBCT. Results: The total cost per patient (in US$) was estimated at $2,176.37, $4,107.01, and $4,356.69 for RBCT, CERA, and EpoB, respectively. The cost-utility ratio was calculated at 4, 423.52, 6,955.50, and 7,406.38 $/QALY for RBCT, CERA, and EpoB, with an ICUR of CERA and EpoB in relation to RBCT at 19,606.40 and 22,466.09 $/QALY, respectively. In sensitivity analysis, the model was most sensitive to hospitalization costs, hospital stay, and annual number of RBCT units. Also, assuming utility and survival improvement with erythropoiesis stimulating agents use resulted in a decrease in ICUR at 13,429 $/QALY for CERA and 15,331 $/QALY for EpoB. In probabilistic sensitivity analysis, the main results of our model were unchanged; CERA and EpoB were more costly and more effective than RBCT below a threshold of 19,500 $/QALY. CERA was the best option for a willingness to pay over 19,500 $/QALY. Limitations: Some model parameters were obtained from observational data, the comparator RBCT is not the standard of care. Conclusion: Our study suggests that managing anemia in dialysis patients with CERA or EpoB may result in better outcomes with higher overall costs. Considering different assumptions, we found substantial variability in the estimates of the cost-utility and incremental of using CERA or EpoB.

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Section: Figurementioning

confidence: 99%

Section: Rbct Requirementmentioning

confidence: 99%

mentioning

confidence: 99%

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The cost-utility of treating anemia with continuous erythropoietin receptor activator or Epoetin versus routine blood transfusions among chronic hemodialysis patients

Maoujoud

Ahid

Cherrah

2016

IJNRD

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“…Thus, when anti‐HCV is tested positive, an expensive HCV RNA reverse‐transcription polymerase chain reaction (RT‐PCR) is mandatory to further test the presence or absence of viremia. In addition, anti‐HCV testing cannot be used to diagnose acute HCV infection due to the delay in generation of detectable anti‐HCV antibodies, and anti‐HCV tests can also be negative in immunocompromised patients, those receiving immunosuppressive therapy, and those on hemodialysis . Although serum HCV RNA RT‐PCR is highly specific and sensitive to detect V‐HCV infection, its dependence on expensive equipment, high cost, and time‐consuming nature limit its applicability, especially in developing countries and regions.…”

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confidence: 99%

“…In addition, anti-HCV testing cannot be used to diagnose acute HCV infection due to the delay in generation of detectable anti-HCV antibodies, and anti-HCV tests can also be negative in immunocompromised patients, those receiving immunosuppressive therapy, and those on hemodialysis. (14,15) Although serum HCV RNA RT-PCR is highly specific and sensitive to detect V-HCV infection, its dependence on expensive equipment, high cost, and time-consuming nature limit its applicability, especially in developing countries and regions. Thus, HCV RNA RT-PCR assay is currently only used to confirm active HCV infection and monitor disease course and response to HCV treatment.…”

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confidence: 99%

A highly specific and sensitive hepatitis C virus antigen enzyme immunoassay for One‐step diagnosis of viremic hepatitis C virus infection

Cui

2016

Hepatology

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The current standard in diagnosing hepatitis C virus (HCV) infection requires two sequential steps: anti-HCV test to screen, followed by HCV RNA reverse-transcription polymerase chain reaction to confirm viremic HCV (V-HCV) infection. HCV core antigen tests provided potential for possible one-step diagnosis. However, low sensitivity and specificity limit their clinical utility. The present study developed a novel HCV antigens enzyme immunoassay (HCV-Ags EIA) and assessed its sensitivity, specificity, and utility for one-step diagnosis of V-HCV infection using 365 serum specimens, including 176 without and 189 with V-HCV infection. First, we confirmed the presence of HCV nonstructural proteins 3, 4b, and 5a besides HCV core antigen during HCV infection and developed a novel HCV-Ags EIA through simultaneous detection of all four HCV proteins. For the first time, the present study demonstrated that serum sample denaturation decreases the test specificity due to release of HCV-Ags sequestered in HCV immune complexes and should not be used in any HCV-Ags, including all the current HCV core antigen assays. On the other hand, using sample nondenaturation, the HCV-Ags EIA results showed 98.9% specificity and 100% sensitivity compared to serum anti-HCV and HCV RNA reverse-transcription polymerase chain reaction results. Using serum sample dilution, and nondenaturation, the lowest limits of detection of the HCV-Ags EIA were equivalent to serum HCV RNA levels of approximate 150-250 IU/mL. Conclusions: The highly specific and sensitive HCV-Ags EIA developed in the present study has the lowest limit of detection equivalent to serum HCV RNA levels of 150-250 IU/mL; using nondenaturation of serum samples, our HCV-Ags EIA reliably differentiated V-HCV infection from resolved HCV infection, accomplishing screening and diagnosis of V-HCV infection in one step. (HEPATOLOGY 2016;64:415-424) C hronic hepatitis C virus (HCV) infection affects approximately 170 million individuals worldwide and is associated with risk of progression to cirrhosis and hepatocellular carcinoma. (1,2) Although health professional practice guidelines advocate screening for HCV infection, recent studies indicated a significant deficit in screening and diagnosis of HCV infection. (3,4) Successful eradication of HCV has been shown to improve the prognosis of HCVinduced liver disease and reduce the associated mortality. (5)(6)(7) Research advances have resulted in clinical application of direct-acting antiviral treatment for HCV infection. All of these treatment regimens are highly safe and effective and associated with >95% sustained virologic response rates. (8)(9)(10) These curative therapies emphasize the essential need for HCV screening and diagnosis to link these individuals to appropriate care.One of the barriers for HCV screening is that the current two-step HCV test process (11,12) is suboptimal, costly, inconvenient, time-consuming, and globally not widely available or affordable. Although the third-

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Faldaprevir for the treatment of genotype-1 hepatitis C virus

Agarwal

Barnabas

2015

Expert Review of Gastroenterology & Hepatology

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Historically, pegylated interferon in combination with ribavirin was the standard of care in hepatitis C virus; however, this combination is often poorly tolerated, has a significant side-effect profile and is of limited efficacy in hepatitis C virus genotype-1. More recently, pegylated interferon/ribavirin has been combined with direct acting antiviral agents such as the first generation NS3/4A protease inhibitors. Faldaprevir, a first generation, second-wave protease inhibitor, when used with a pegylated interferon/ribavirin regimen, has also been shown to increase treatmentsuccess while shortening treatment duration; however, second generation direct acting antiviral agents offer even betterefficacy and tolerability. Various direct acting antiviral agent combinations in interferon-free regimens have been effective in over 95% of patients and are now in licensed use. While faldaprevir was a pioneering drug, by the time it reached late phase development it was superseded by newer agents.

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Diagnosis and evaluation of hepatitis C virus among haemodialysis patients

Cited by 6 publications

References 14 publications

The cost-utility of treating anemia with continuous erythropoietin receptor activator or Epoetin versus routine blood transfusions among chronic hemodialysis patients

The cost-utility of treating anemia with continuous erythropoietin receptor activator or Epoetin versus routine blood transfusions among chronic hemodialysis patients

A highly specific and sensitive hepatitis C virus antigen enzyme immunoassay for One‐step diagnosis of viremic hepatitis C virus infection

Faldaprevir for the treatment of genotype-1 hepatitis C virus

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