Management of hepatitis C virus infection in hemodialysis patients

Yu, Yuecheng; Wang, Yue; He, Changyu; Wang, Maorong; Wang, Yuming

doi:10.4254/wjh.v6.i6.419

Cited by 13 publications

(14 citation statements)

References 52 publications

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“…aggravation of liver fibrosis (F) [1]; the risk of complications related to liver puncture biopsy (LPB) is higher, 13.2 % [1]. Prevalence is significantly correlated with the length of time on HD and the processed blood volume [6][7][8][9].…”

Section: Introductionmentioning

confidence: 97%

Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients

et al. 2015

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Section: Introductionmentioning

confidence: 97%

Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients

et al. 2015

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“…Ribavirin (RBV) was considered to be contraindicated in hemodialysis patients because of the possible development of hemolytic anemia. 9,10 However, several studies reported the use of low-dose ribavirin in combination with interferon, carefully controlling for anemia and monitoring serum concentration of the drug during treatment in hemodialysis patients. [11][12][13] The primary goal of the antivirological treatment is eradication of the HCV infection, which is synonymous with sustained virological response (SVR).…”

Section: Introductionmentioning

confidence: 99%

Single nucleotide polymorphisms near IL28B gene and response to treatment of chronic hepatitis C in hemodialysis patients

Dzekova‐Vidimliski¹,

Nikolov²,

Matevska-Geshkovska

et al. 2015

Renal Failure

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Background: It has been shown that single nucleotide polymorphisms (SNPs) near the interleukin 28B (IL28B) gene were associated with sustained virological response following standard antivirological treatment of chronic hepatitis C. Objectives: The aim of the study was to evaluate the association between SNPs near the IL28B gene and response to the treatment of chronic hepatitis C in hemodialysis patients. Patients and methods: The study group included 24 hemodialysis patients with chronic hepatitis C routinely treated with pegylated interferon a-2 a. HCV genotype 1 was the cause of chronic hepatitis C in all study participants. Sustained virological response was determined by an assay with a sensitivity of 20 IU/mL, 6 months after completion of the antivirological treatment. The genotyping of the three most widely studied IL28B gene polymorphisms (rs12979860, rs8099917, and rs12980275) was performed in all study participants. Results: Sustained virological response was achieved in 50% of the treated patients. The treatment response was significantly associated with the CC genotype of rs12979860, TT genotype of rs8099917, and AA genotype of rs12980275 (p ¼ 0.003, p ¼ 0.009, and p ¼ 0.012, respectively). Conclusions: The three most widely studied SNPs near the IL28B gene were associated with sustained virological response following antivirological treatment of chronic hepatitis C in hemodialysis patients.

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“…The hemodialysis procedure requires vascular access for prolonged periods and thus put patients on long-term hemodialysis at increased risk of acquiring HCV infection [2,3]. The reported prevalence of anti-HCV or HCV infection among hemodialysis population is much higher than that of the general population [4,5,6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

“…Following the implementation of appropriate precautions for infection control, the prevalence of hepatitis C had declined recently [8,17,18,19]. However, it also increased the mortality and morbidity in hemodialysis patients [8,20,21]. …”

Section: Introductionmentioning

confidence: 99%

“…Thus, CDC recommends routine testing for anti-HCV among patients on long-term hemodialysis and appropriate monitoring should be undertaken to minimize HCV transmission between hemodialysis patients [14,15,16]. Following the implementation of appropriate precautions for infection control, the prevalence of hepatitis C had declined recently [8,17,18,19]. However, it also increased the mortality and morbidity in hemodialysis patients [8,20,21].…”

Section: Introductionmentioning

confidence: 99%

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Utilization of Signal-to-Cutoff Ratio of Hepatitis C Virus Antibody Assay in Predicting HCV Viremia among Hemodialysis Patients

Kao

Chen

Lin

et al. 2015

Nephron

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Background: Hepatitis C virus (HCV) infection is a common cause of acute and chronic hepatitis among the hemodialysis population. To prevent cross infection between hemodialysis patients during the hemodialysis procedure, routine screening of anti-HCV antibody is recommended. However, a reactive anti-HCV EIA test is not equal to active HCV infection. An expensive RT-PCR study is required to confirm HCV viremia. This will significantly increase the cost burden because payment for each hemodialysis treatment is very low in Taiwan. Thus, it is useful to identify parameters that could predict HCV viremia among anti-HCV-reactive patients. In this study, we examined the usefulness of signal-to-cut (S/CO) ratio of anti-HCV antibody in discriminating HCV viremia from non-viremia among the anti-HCV-reactive hemodialysis population. Materials and Methods: In a cross-sectional measurement of anti-HCV antibody among 369 chronic hemodialysis patients, 44 showed reactive and 9 grey zone reaction for anti-HCV. These 53 patients underwent further blood tests for the measurement of AST, ALT and HCV RNA (by RT-PCR). The results of RT-PCR were used as a dependent variable. Then, S/CO ratios of anti-HCV, serum AST, ALT levels, age and duration of hemodialysis were used as independent variables to undergo ROC curve and logistic regression analysis. Results: Thirty-six of the 53 reactive and grey zone patients were positive for HCV RNA in the RT-PCR study. Patients who were positive for HCV RNA had a higher S/CO ratio (p < 0.01), higher AST and ALT levels (p < 0.01), and longer duration on hemodialysis (p < 0.05) than those negative for HCV RNA. Logistic regression revealed that only S/CO ratio was a significant predictor for HCV viremia (p = 0.004). ROC curve analysis showed that S/CO ratio had a highest area under curve (0.967, p < 0.001), followed by ALT (0.826, p < 0.001), AST (0.778, p = 0.001), duration on hemodialysis (0.606, p = 0.215) and age (0.426, p = 0.386) in discriminating HCV viremia from non-viremia. Using a cutoff S/CO ratio of 65, we can confirm HCV viremia with a diagnostic specificity of 100%, sensitivity of 80.1% and positive predictive value of 100%. Conclusion: S/CO ratio is a useful indicator in predicting HCV viremia among anti-HCV-reactive hemodialysis patients. Patients with an S/CO ratio >65 can be regarded as those with active HCV infection. Alternatively, patients with reactive anti-HCV but with an S/CO ratio <65 should receive further RT-PCR test.

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Management of hepatitis C virus infection in hemodialysis patients

Cited by 13 publications

References 52 publications

Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients

Serum hyaluronic acid in chronic viral hepatitis B and C: a biomarker for assessing liver fibrosis in chronic hemodialysis patients

Single nucleotide polymorphisms near IL28B gene and response to treatment of chronic hepatitis C in hemodialysis patients

Utilization of Signal-to-Cutoff Ratio of Hepatitis C Virus Antibody Assay in Predicting HCV Viremia among Hemodialysis Patients

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