Validation of Biochemical Markers for the Prediction of Liver Fibrosis and Necroinflammatory Activity in Hemodialysis Patients with Chronic Hepatitis C

Canbakan, Mustafa; Şentürk, Hakan; Canbakan, Billur; Toptaş, Tayfur; Tabak, Ömür; Özaras, Reşat; Tabak, Fehmı; Balcı, Huriye; Süt, Necdet; Özbay, Gülşen

doi:10.1159/000320751

Cited by 19 publications

(20 citation statements)

References 56 publications

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“…Percutaneous liver biopsy constitutes the most reliable tool for examining the effects of HCV infection (i.e., stage of liver disease) and ruling out possible other concomitant liver diseases [31] . Neither HCV RNA viral load nor liver enzymes reflect the severity of liver injury decisively [32,33] . Liver enzyme activity and quantity of HCV RNA can fluctuate during HCV infection, whereas fibrosis is progressive and largely irreversible.…”

Section: Diagnosis Of Hcv Infection In Patients With Esrdmentioning

confidence: 99%

Hepatitis C infection in hemodialysis patients: A review

Etık

Öcal

Boyacioglu

2015

WJH

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Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications posttransplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.

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Section: Diagnosis Of Hcv Infection In Patients With Esrdmentioning

confidence: 99%

Hepatitis C infection in hemodialysis patients: A review

Etık

Öcal

Boyacioglu

2015

WJH

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“…In a study which included 203 subjects, we demonstrated good performance of this model, especially in excluding significant fibrosis, with a negative predictive value (NPV) of 93% for a prevalence of significant fibrosis of 24% [38] . These results were further validated in a cohort of 279 hemodialysis patients [39] and Canbakan et al [40] showed that APRI was superior to FibroTest ® in this population.…”

Section: Serum Biomarkersmentioning

confidence: 72%

Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

Schiavon

Narciso-Schiavon

Carvalho-Filho

2014

WJG

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Assessment of liver fibrosis in chronic hepatitis C virus (HCV) infection is considered a relevant part of patient care and key for decision making. Although liver biopsy has been considered the gold standard for staging liver fibrosis, it is an invasive technique and subject to sampling errors and significant intra- and inter-observer variability. Over the last decade, several noninvasive markers were proposed for liver fibrosis diagnosis in chronic HCV infection, with variable performance. Besides the clear advantage of being noninvasive, a more objective interpretation of test results may overcome the mentioned intra- and inter-observer variability of liver biopsy. In addition, these tests can theoretically offer a more accurate view of fibrogenic events occurring in the entire liver with the advantage of providing frequent fibrosis evaluation without additional risk. However, in general, these tests show low accuracy in discriminating between intermediate stages of fibrosis and may be influenced by several hepatic and extra-hepatic conditions. These methods are either serum markers (usually combined in a mathematical model) or imaging modalities that can be used separately or combined in algorithms to improve accuracy. In this review we will discuss the different noninvasive methods that are currently available for the evaluation of liver fibrosis in chronic hepatitis C, their advantages, limitations and application in clinical practice.

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“…These non-invasive tests have been validated neither in hemodialysis patients nor in kidney transplant recipients, given that they are less accurate than in the general population [17][18][19][20]. The assessment of liver stiffness by elastography is imperfect in this population, even if it is superior in staging the severity of hepatic fibrosis, compared with biochemical markers [20,21].…”

Section: Non-invasive Markers Of Fibrosis and Liver Biopsy In Evaluatmentioning

confidence: 99%

How Manage HCV Patients on Hemodialysis?

Corouge

Vallet-Pichard

Pol

2015

Curr Hepatology Rep

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The prevalence of hepatitis C virus (HCV) infection remains higher in dialysis patients than in the general population, and HCV chronic infection results in significant morbidity and mortality. This negative impact evidences the need of regular screening, fibrosis evaluation, and antiviral treatment with the new direct antiviral agents (DAAs). In dialysis patients, DAAs should be given in all patients with whatever fibrosis stage and whether or not they are candidates for kidney transplantation. The grazoprevir/elbasvir or the paritaprevir/ritonavir, ombitasvir, dasabuvir±ribavirin combinations reached high sustained virological response (SVR). Sofosbuvir is not recommended in patients with a glomerular filtration rate (GFR) below 30 mL/min. Lower daily doses of sofosbuvir and ribavirin led to disappointing results. Several studies with sofosbuvir plus simeprevir or daclatasvir or ledispasvir reported high SVR and good tolerance, but the optimal dose of sofosbuvir in dialysis patients needs to be clarified. Additional clinical trials of DDAs in late chronic kidney disease (CKD) are definitely needed.

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Validation of Biochemical Markers for the Prediction of Liver Fibrosis and Necroinflammatory Activity in Hemodialysis Patients with Chronic Hepatitis C

Cited by 19 publications

References 56 publications

Hepatitis C infection in hemodialysis patients: A review

Hepatitis C infection in hemodialysis patients: A review

Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

How Manage HCV Patients on Hemodialysis?

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