Low levels of hepatitis C virus RNA in blood of infected patients under maintenance haemodialysis with high-biocompatibility, high-permeability filters

Angélico, M.; Morosetti, Massimo; Passalacqua, S.; Chiappini, Maria Grazia; Botta, S.; Ombres, Domenico; Splendiani, G; Casciani, Carlo Umberto

doi:10.1016/s1590-8658(00)80337-0

Cited by 9 publications

(10 citation statements)

References 18 publications

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“…The HCV RNA reduction in patients treated by dialysis showed variable degrees ranging from 15% to 78% [Okuda et al, 1996;Adorati et al, 1999;Ishida et al, 2004]. However, some of the patients even had a rise in the level of HCV-RNA, as described previously [Angelico et al, 2000]. Interferon therapy would probably show higher efficacy in patients showing reduction of their HCV viral load during dialysis sessions.…”

Section: Discussionsupporting

confidence: 58%

Kinetics of hepatitis C viral RNA and HCV‐antigen during dialysis sessions: Evidence for differential viral load reduction on dialysis

Kaiser

Damerow

Tenckhoff

et al. 2008

Journal of Medical Virology

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Hepatitis C infection is a common problem in dialysis units. The prevalence ranges from 3% to more than 50%. Several reports have described a variable reduction of HCV-RNA during hemodialysis treatment sessions. But so far nothing is known about the HCV antigenemia or the kinetics of the reduction of HCV-RNA and HCV antigenemia during these sessions. HCV-RNA was monitored using the VERSANT HCV bDNA assay 3.0 (Bayer Healthcare Diagnostics, Leverkusen, Germany) or the HCV-Monitor TaqMan (Roche Diagnostics). HCV antigenemia was tested by using Ortho-trac-C assay (Ortho Clinical Diagnostics, Neckargemünd, Germany). Kinetics of HCV-RNA were available in 15 dialysis sessions measured by bDNA assay and in 5 dialysis sessions measured by rt-PCR. Quantitative HCV-antigenemia was available in fourteen dialysis sessions. Not only HCV-RNA but as expected also the HCV-antigenemia fell during the dialysis session. However, while the average reduction of HCV-antigen appears steady and linear, the level of HCV-RNA seems to be stable during the first 3 hr of dialysis, and decreases rapidly during the last 2 hr. The results seem to be independent of the HCV-RNA detection method. The different kinetics of HCV RNA and HCV antigen load suggest that there are different mechanisms responsible for the reduction of the HCV antigen and HCV-RNA, respectively. Reduction of viral load during dialysis session indicates a potential benefit of dialysis in case of HCV associated antiviral therapy.

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Section: Discussionsupporting

confidence: 58%

Kinetics of hepatitis C viral RNA and HCV‐antigen during dialysis sessions: Evidence for differential viral load reduction on dialysis

Kaiser

Damerow

Tenckhoff

et al. 2008

Journal of Medical Virology

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“…However, only a few patients (10%) underwent haemodialysis with cellulosic membranes in our study group; thus, this point should be addressed in a larger population. Some authors found differences in the kinetics of viral load according to the type of membrane used in dialysis patients infected with HCV [33] but conflicting results have been published [14,26,27].…”

Section: Discussionmentioning

confidence: 99%

Kinetics of hepatitis B virus load and haemodialysis: a prospective study

Fabrizi

Lunghi

Alongi³

et al. 2008

Journal of Viral Hepatitis

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The efficacy of monotherapy with interferon (IFN) (conventional or pegylated IFN) in dialysis patients with chronic hepatitis C remains unclear, although a number of clinical trials have been published addressing this issue. The aim of the study was to evaluate the efficacy and safety of monotherapy by conventional or pegylated IFN in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical trials. The primary outcome was sustained virological response (SVR; as a measure of efficacy), and the secondary outcome was drop-out rate (as a measure of tolerability). We used the random-effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses. We identified 28 clinical trials (645 unique patients), of which six (21.4%) had a controlled design. In the group of trials based on conventional IFN, the summary estimate for SVR and drop-out rate was 39% [95% confidence interval (CI) 32-46] and 19% (95% CI 13-26) respectively. The summary estimate for SVR rate in patients with the hepatitis C virus genotype 1 was 33% (95% CI 19-47). In the subset of trials using pegylated IFN, the summary estimate for SVR and drop-out rate was 31% (95% CI 7-55) and 27% (95% CI 1-52) respectively. The most frequent side-effects requiring interruption of treatment were flu-like symptoms, and gastrointestinal and haematological changes. A relationship between age and drop-out rate was found, even if no statistical significance was reached (P = 0.064). The studies were heterogeneous with regard to SVR and drop-out rate. No publication bias was observed. One-third of dialysis patients with chronic hepatitis C were successfully treated with conventional or pegylated IFN monotherapy. Preliminary evidence does not support additional benefit due to monotherapy with pegylated IFN on the viral response in the chronic kidney disease (CKD) population. Tolerance to IFN monotherapy was unsatisfactory, particularly to pegylated IFN. The optimal antiviral treatment of chronic hepatitis C in dialysis populations is currently under active investigation.

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“…Cruzado et al, (2003) proved that patients previously treated with interferon were less at risk of developing MPGN. (Angelico et al, 2000). ALT, as mentioned previously, is a helpful, although non-specific, marker of the presence of HCV infection in the dialysis population.…”

Section: Hepatitis C Virus (Hcv) In Renal Patientsmentioning

confidence: 85%

“…Several dilemmas regarding the management of these patients have yet to be resolved: 1. Should HCV-RNA testing and complete HBV serologies be included in the routine screening of HD population for chronic hepatitis infection, considering the fact that anti-HCV remains positive even in cured patients and that in some RNA-HCV positive cases, antibodies may be negative ("occult-hepatitis") (Angelico et al, 2000 …”

Section: Risk Factors (Table 2) Some Concernsmentioning

confidence: 99%

The Present Role of Liver Biopsy in Kidney Transplant Candidates in the Management of Hepatitis B and C Patients

Casanovas¹,

Baliellas²,

Cala³

2011

Liver Biopsy in Modern Medicine

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Low levels of hepatitis C virus RNA in blood of infected patients under maintenance haemodialysis with high-biocompatibility, high-permeability filters

Cited by 9 publications

References 18 publications

Kinetics of hepatitis C viral RNA and HCV‐antigen during dialysis sessions: Evidence for differential viral load reduction on dialysis

Kinetics of hepatitis C viral RNA and HCV‐antigen during dialysis sessions: Evidence for differential viral load reduction on dialysis

Kinetics of hepatitis B virus load and haemodialysis: a prospective study

The Present Role of Liver Biopsy in Kidney Transplant Candidates in the Management of Hepatitis B and C Patients

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