Influence of Hepatitis B Virus Virema upon Serum Aminotransferase Activity in Dialysis Population

Fabrizi, Fabrizio; Mangano, Stefano; Alongi, G.; Bisegna, Sergio; Finazzi, Silvia; Lunghi, G.; Ponticelli, Claudio

doi:10.1177/039139880302601202

Cited by 25 publications

(25 citation statements)

References 38 publications

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“…[1][2][3][4] It is thought that liver injury associated with HBV infection is mediated by both viral factors and host immune response. [1,5] However, cellular immunity is often depressed in the uremic patients, [5][6][7][8] raising the question of why the clinical outcome of HBV infection in HD patients is different from that in the general population. On the other hand, is the viral factor of the uremic patients different from the general population?…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] A revised cutoff value of ALT (17 IU/L) for the uremic patients had been described previously.…”

Section: Definition Of High Alt Levelmentioning

confidence: 99%

“…[1][2][3][4] However, the natural course of hepatitis B virus (HBV) infection of the uremic patients remains unclear. [5][6][7][8][9][10][11] Recently, the REVEAL-HBV study from Taiwan demonstrate that an elevated viral load, serum HBV DNA level, is a strong risk factor predicting HCC and liver cirrhosis in HBV carrier. [12,13] As a few studies report, uremic patients with HBV infection usually have a low viral load.…”

Section: Introductionmentioning

confidence: 99%

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Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

et al. 2008

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Background and aims. The effect of hemodialysis (HD) to change the viral load of hepatitis B virus (HBV) in uremic patients with chronic HBV infection has never been studied. In this study, we investigated the HBV viral loads and their changes between the HD procedure in the uremic patients. Patients and methods. A total of 38 chronic HBV-infected uremic patients were enrolled, but eight cases were excluded due to HCV co-infection and under anti-viral therapy. To evaluate the HBV DNA levels and their changes through the course of HD, we quantified serial serum samples from each patient immediately before HD, at the end of HD, and 48 hours later-immediately before the next HD. Results. Most of our HBV-infected uremic patients had a relatively lower HBV viral load; 80% cases with HBV DNA Ϲ4 Log 10 copies/mL, in comparison with the Taiwan epidemiologic study for community base HBV carriers. There was no significant difference of HBV DNA level between HBeAg-positive and -negative patients, but a significant higher DNA level in the high ALT group (p = 0.029) and liver cirrhosis patients (p = 0.002). The mean HBV DNA levels, before and after HD, respectively, in our 30 patients were 3.823 ± 1.130 Log 10 copies/mL and 3.686 ± 1.114 Log 10 copies/mL. It was a significant decrease on HBV DNA level in chronic HBV-infected patients through HD procedure (p = 0.004). The mean HBV DNA level of two days after HD was 3.702 ± 1.094 Log 10 copies/ mL, which was not significantly different from the HBV DNA level before (p = 0.076) or after (p = 0.267) HD; however, the mean reduction of HBV DNA by a single HD was 0.11 ± 0.38 Log 10 copies/mL. Patients with low viral load also had a signifi-

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Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] A revised cutoff value of ALT (17 IU/L) for the uremic patients had been described previously.…”

Section: Definition Of High Alt Levelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

et al. 2008

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“…The patients enrolled in the present study were from a population of 812 patients undergoing regular dialysis for ESRD in six dialysis units in Italy. The epidemiological features of HBV and HCV infections in this population had been previously reported (13). In our panel of specimens, we identified by ELISA HCV 3.0 the anti-HCV-positive patients (n ϭ 180) present in a population of 812 patients; the anti-HCV-negative sera used (n ϭ 125) were randomly included from the subset of 632 anti-HCV-negative patients.…”

Section: Methodsmentioning

confidence: 99%

Novel Assay Using Total Hepatitis C Virus (HCV) Core Antigen quantification for Diagnosis of HCV Infection in Dialysis Patients

Fabrizi¹,

Lunghi

Aucella

et al. 2005

J Clin Microbiol

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Dialysis patients remain a high-risk group for hepatitis C virus (HCV) infection. The current diagnosis of HCV infection among dialysis patients includes serological assays and nucleic acid amplification technology (NAT) for assessing serum anti-HCV antibody and HCV viremia, respectively. However, current NAT techniques are expensive and labor-intensive and often lack standardization. An assay prototype designed to detect and quantify total HCV core antigen (total HCV core Ag) protein in serum and plasma in the presence or absence of anti-HCV antibodies has been recently developed. A comparison between a total anti-HCV core Ag enzyme-linked immunosorbent assay (ELISA) and a quantitative HCV RNA assay based on reverse transcription-PCR (RT-PCR) (Amplicor HCV Monitor test) was performed using a large (n ‫؍‬ 305) cohort of ELISA HCV 3.0 HCV-negative and -positive patients on maintenance dialysis. The concentrations of HCV core Ag and HCV RNA levels (measured by RT-PCR) were significantly correlated (r ‫؍‬ 0.471, P ‫؍‬ 0.0001) over a wide range of HCV RNA levels and were maintained among different HCV genotypes (HCV genotype 1, r ‫؍‬ 0.862, P ‫؍‬ 0.0001; HCV genotype 2, r ‫؍‬ 0.691, P ‫؍‬ 0.0001). We estimated that 1 pg of total HCV core Ag per ml is equivalent to approximately 19.952 IU of HCV RNA per ml, even if the wide range in the ratio of core Ag to HCV RNA (95% confidence intervals, 2.8 ؋ 10 3 to 1.6 ؋ 10 5 IU/ml) precluded definitive conclusions. In summary, total HCV core Ag proved to be useful for performing HCV RNA measurement among dialysis patients in routine laboratories without the need for special equipment or training. The present study supports the use of the total anti-HCV core Ag ELISA for assessing viral load among dialysis patients with HCV infection.Dialysis patients remain a high-risk group for hepatitis C virus (HCV) infection (11). The Centers for Disease Control and Prevention, Atlanta, Ga., have recently included semiannual anti-HCV testing for anti-HCV-negative patients in their infection control practices for hemodialysis units (6, 7).Routine diagnosis of HCV is based on detection of anti-HCV antibody. However, due to the absence of an efficient in vitro culture system for HCV or assays capable of detecting viral antigens, direct detection of HCV has depended on nucleic acid amplification technology (NAT) techniques. Indeed, serological assays for detecting anti-HCV antibody cannot distinguish between patients with active infection and those who have cleared the virus (29). NAT tests are based on nucleic acid amplification (PCR and transcription-mediated amplification) (16, 37) or signal amplification (branched-chain DNA assay) and are currently used to detect viremia (2, 36). Recently both assay systems have become semiautomated. Several problems still persist with these methods; PCR requires considerable skill and has limited reproducibility, while the branched-chain DNA assay requires a long incubation period. Both assays are also expensive. An assay prototype designed to detect and ...

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“…Introduction of HBV vaccination, isolation of HBV positive patients, use of dedicated dialysis machines and regular surveillance for HBV infection has dramatically reduced the spread of HBV in this setting [6][7][8][9][10] . However, the frequency of HBV infection in patients undergoing maintenance dialysis in the industrialized world is low, but not negligible [11][12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B viral infection in maintenance hemodialysis patients: A three year follow-up

Cao¹

2007

WJG

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AIM:To observe the prevalence of hepatitis B virus (HBV) infection in maintenance hemodialysis patients. METHODS:Eighty-eight hemodialysis patients who had been receiving hemodialysis regularly for an average of 39.45 ± 7.57 (range from 36 to 49) mo were enrolled in this study. HBV markers were measured in these patients before hemodialysis and in 100 healthy controls by the chemiluminescent microparticle immunoassay (CMI) method in order to compare the incidence of HBV infection in hemodialysis patients versus normal healthy people. All patients were then divided into two groups: patients positive for HBV markers (i.e. those positive for HBsAg, anti-HBc, HBeAg, anti-HBe, with or without positive anti-HBs) (n = 33), and patients negative for HBV markers (including those only positive anti-HBs) (n = 55). The following information was obtained for all patients: socio-demographic data, number of blood transfusions and some laboratory investigations. After 39.45 ± 7.57 mo follow-up, HBV markers were measured in these patients by CMI. R E S U LT S :T h e i n c i d e n c e o f H B V i n f e c t i o n i n maintenance hemodialysis patients was 37.5%, which was higher than in controls (9%). In the patients positive for HBV markers, there were 13 patients (39.4%) who had a history of blood transfusion, which was more than the number [12 (21.8%), P = 0.04] of patients negative for HBV markers. Eight of the 88 patients negative for HBV markers turned out to be positive, while three of the 33 patients positive for HBV markers turned out to be negative. There was no cirrhosis of the liver or hepatoma occurring in these patients. CONCLUSION:Maintenance hemodialysis patients have a higher risk of HBV infection than the average population. The number of blood transfusions is associated with an increased prevalence of HBV. While it is hard for hemodialysis patients to eliminate HBV, the prognosis of patients with positive HBV markers is good.

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Influence of Hepatitis B Virus Virema upon Serum Aminotransferase Activity in Dialysis Population

Cited by 25 publications

References 38 publications

Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

Novel Assay Using Total Hepatitis C Virus (HCV) Core Antigen quantification for Diagnosis of HCV Infection in Dialysis Patients

Hepatitis B viral infection in maintenance hemodialysis patients: A three year follow-up

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