Hepatitis C virus screening and clinical monitoring of biomarkers in patients undergoing hemodialysis

Maia, Laura Patrícia Viana; Martins‐Filho, Olindo Assis; Teixeira-Carvalho, Andréa; Speziali, Elaine; Vermhren, Rolandro; Lira, Edson; Lima, Tatiane Amabile de; Braga, Wornei Silva Miranda; Torres, Kátia Luz; Malheiro, Adriana

doi:10.1002/jmv.21521

Cited by 10 publications

(5 citation statements)

References 47 publications

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“…Our results are at variance with that of Maia et al., who found that a lower percentage of circulating CD3 (+) and CD4 (+) T cells was found in patients seronegative for HCV, whereas a higher frequency of CD8 (+) T cells was the hallmark of patients with HCV.…”

Section: Discussioncontrasting

confidence: 99%

Study of peripheral blood natural killer cells, T‐cell helper/T‐cell suppressor ratio and intercurrent infection frequency in hepatitis C seropositive prevalent hemodialysis patients

Ibrahim

Mostafa

El-Said

et al. 2014

Hemodialysis International

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Hemodialysis (HD) may adversely affect the immune system. It is established that intercurrent infection rate and severity may be increased in prevalent HD patients. Moreover, hepatitis C viral infection, a common infection in many HD centers, may further inhibit the immune system. To our knowledge, no previous study in the literature has attempted to investigate the possible effects of hepatitis C seropositivity on rate and severity of intercurrent infection in prevalent HD patients. The aim of this study was to assess the peripheral blood CD16-natural killer cells, CD4/CD8 ratio, as well as rate of intercurrent infection in hepatitis C seropositive prevalent HD patients as compared with hepatitis C seronegative prevalent HD patients. Twenty hepatitis C seropositive stable prevalent HD patients (group A), as well as another twenty hepatitis C seronegative stable prevalent HD patients (group B), were randomly selected from our HD unit and enrolled in the study. Both groups were similar in age, sex, body mass index, and duration of HD. Diabetics, smokers, and cases with advanced liver disease (Child classification stages B and C) were excluded from the study. A third group (group C) of 10 apparently healthy subjects (of similar age, sex, and body mass index), was also enrolled in the study. All subjects were investigated by complete blood count, routine chemistry, assessment of peripheral lymphocytes CD3,CD16, CD4, CD8, CD4/CD8 ratio by flow cytometer, as well assessment of intercurrent infection frequency retrospectively (since the start of HD therapy and seroconversion in HD patients, and prospectively for a period of six months. Although we detected statistically significant higher frequency of intercurrent infection in both HD groups compared with the healthy group, we did not detect significant differences between hepatitis C seropositive and seronegative groups regarding frequency or severity of intercurrent infection. Moreover, we did not detect significant differences among the three studied groups regarding levels of CD16, CD3, CD4, CD8, CD4/CD8 ratio in peripheral lymphocytes. It may be concluded that hepatitis C seropositive prevalent HD patients are not at increased risk of intercurrent infection as compared with hepatitis C seronegative prevalent HD patients, contrary to what is reported in hepatitis C seroconverted organ transplant candidates.

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Section: Discussioncontrasting

confidence: 99%

Study of peripheral blood natural killer cells, T‐cell helper/T‐cell suppressor ratio and intercurrent infection frequency in hepatitis C seropositive prevalent hemodialysis patients

Ibrahim

Mostafa

El-Said

et al. 2014

Hemodialysis International

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“…from 4 clinics (NI) 54.4 22 90 56.3 76.0 Callegaro et al, 2006 21 Pop. from 1 clinic (NI) – – – – – Maia et al, 2009 42 Pop de 1 clinic (NI) – – – – – Leão et al, 2010 43 Pop. from 1 clinic (0%) 55.1 – – 46.2 74.0 da Silva et al, 2013 44 Pop.…”

Section: Resultsmentioning

confidence: 99%

Persistently high hepatitis C rates in haemodialysis patients in Brazil [a systematic review and meta-analysis]

Niquini

Mota

Bastos

et al. 2022

Sci Rep

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We conducted a systematic review and meta-analysis of studies assessing HCV infection rates in haemodialysis patients in Brazil (Prospero CRD #42021275068). We included studies on patients under haemodialysis, comprising both convenience samples and exhaustive information from selected services. Patients underwent HCV serological testing with or without confirmation by HCV RNA PCR. Exclusion criteria were the following: absence of primary empirical information and studies without information on their respective settings, study year, accurate infection rates, or full specification of diagnostic tests. Studies with samples ≤ 30 and serial assessments with repeated information were also excluded. Reference databases included PubMed, LILACS, Scopus, and Web of Science for the period 1989–2019. A systematic review was carried out, followed by two independent meta-analyses: (i) studies with data on HCV prevalence and (ii) studies with a confirmatory PCR (i.e., active infection), respectively. A comprehensive set of different methods and procedures were used: forest plots and respective statistics, polynomial regression, meta-regression, subgroup influence, quality assessment, and trim-and-fill analysis. 29 studies and 11,290 individuals were assessed. The average time patients were in haemodialysis varied from 23.5 to 56.3 months. Prevalence of HCV infection was highly heterogeneous, with a pronounced decrease from 1992 to 2001, followed by a plateau and a slight decrease in recent years. The summary measure for HCV prevalence was 34% (95% CI 26–43%) for studies implemented before 2001. For studies implemented after 2001, the corresponding summary measure was 11% (95% CI 8–15%). Estimates for prevalence of active HCV infection were also highly heterogeneous. There was a marked decline from 1996 to 2001, followed by a plateau and a slight increase after 2010. The summary measure for active HCV infection was 19% (95% CI 15–25%) in studies carried out before 2001. For studies implemented after 2001, the corresponding summary measure was 9% (95% CI 6–13%). Heterogeneity was pervasive, but different analyses helped to identify its underlying sources. Besides the year each study was conducted, the findings differed markedly between geographic regions and were heavily influenced by the size of the studies and publication biases. Our systematic review and meta-analysis documented a substantial decline in HCV prevalence among Brazilian haemodialysis patients from 1992 to 2015. CKD should be targeted with specific interventions to prevent HCV infection, and if prevention fails, prompt diagnosis and treatment. Although the goal of HCV elimination by 2030 in Brazil remains elusive, it is necessary to adopt measures to achieve micro-elimination and to launch initiatives towards targeted interventions to curb the spread of HCV in people with CKD, among other high-risk groups. This is of particular concern in the context of a protracted COVID-19 pandemic and a major economic and political crisis.

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“…The reasons for an elevated EOC in CKD patients are unclear and may be multifactorial. Suggested potential mechanisms include an increased turnover rate of eosinophils in bone marrow [11,12], allergic reactions to extracorporeal processes [10] and associations with hepatitis or specific medications [10,13]. However, none of these potential explanations were confirmed by further investigation.…”

Section: Introductionmentioning

confidence: 99%

Eosinophil count and mortality risk in incident hemodialysis patients

Kang

Lee

Kleine

et al. 2020

Nephrology Dialysis Transplantation

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Background Eosinophils are traditionally known as moderators of allergic reactions; however, they have now emerged as one of the principal immune-regulating cells as well as predictors of vascular disease and mortality in the general population. Although eosinophilia has been demonstrated in hemodialysis (HD) patients, associations of eosinophil count (EOC) and its changes with mortality in HD patients are still unknown. Methods In 107 506 incident HD patients treated by a large dialysis organization during 2007–11, we examined the relationships of baseline and time-varying EOC and its changes (ΔEOC) over the first 3 months with all-cause mortality using Cox proportional hazards models with three levels of hierarchical adjustment. Results Baseline median EOC was 231 (interquartile range 155–339) cells/μL and eosinophilia (>350 cells/μL) was observed in 23.4% of patients. There was a gradual increase in EOC over time after HD initiation with a median ΔEOC of 5.1 (IQR −53–199) cells/μL, which did not parallel the changes in white blood cell count. In fully adjusted models, mortality risk was highest in subjects with lower baseline and time-varying EOC (<100 cells/μL) and was also slightly higher in patients with higher levels (≥550 cells/μL), resulting in a reverse J-shaped relationship. The relationship of ΔEOC with all-cause mortality risk was also a reverse J-shape where both an increase and decrease exhibited a higher mortality risk. Conclusions Both lower and higher EOCs and changes in EOC over the first 3 months after HD initiation were associated with higher all-cause mortality in incident HD patients.

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Hepatitis C virus screening and clinical monitoring of biomarkers in patients undergoing hemodialysis

Cited by 10 publications

References 47 publications

Study of peripheral blood natural killer cells, T‐cell helper/T‐cell suppressor ratio and intercurrent infection frequency in hepatitis C seropositive prevalent hemodialysis patients

Study of peripheral blood natural killer cells, T‐cell helper/T‐cell suppressor ratio and intercurrent infection frequency in hepatitis C seropositive prevalent hemodialysis patients

Persistently high hepatitis C rates in haemodialysis patients in Brazil [a systematic review and meta-analysis]

Eosinophil count and mortality risk in incident hemodialysis patients

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