The prognosis of hepatitis C virus on hemodialysis patients
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Abstract:
Objectives Analyzed the association between hepatitis C virus (HCV) infection and clinical outcome in maintenance hemodialysis. Methods Retrospective study of 106 patients died after initiation dialysis one year. They were divided into Anti-HCV+ and Anti-HCV-. Results Anti-HCV+ were significant higher liver enzymes, lower serum albumin and dialysis vintage. Cardiovascular mortality was the common cause of death in both groups.Conclusions Maintenance hemodialysis patients infected hepatitis C virus had poor outcome.
Key words:
Hepatitis C-Like Viruses; Hemodialysis; PrognosisKeywords:
Hepatitis C
Hepatitis C virus (HCV) infection is highly prevalent among chronic dialysis patients and is the most common cause of chronic liver disease. Ninety six patients on chronic hemodialysis in our institute of transfusiology at the Military Medical Academy were evaluated for the presence of HCV infection. There was a significant relationship between presence of anti-HCV antibodies and number of blood transfusion received by examined patients. We concluded that hepatitis C is a common problem among patients on chronic hemodialysis in our institution: HCV infection is proved in about 48.95% of all patients on hemodialysis.
Chronic infection
Hepatitis C
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Bone disease
Hepatitis C
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Abstract: The hepatitis B virus (HBV) can be transmitted in the dialysis setting through blood transfusions and environmental surfaces. Transfusion related hepatitis C virus (HCV) infection is very well known, but only recently the environmental transmission of this virus was postulated. In order to study the prevalence, mechanisms of transmission, and the ALT patterns of HBV and HCV infections in hemodialysis and CAPD patients before the implementation of HBV vaccination and HCV screening in the blood bank, we conducted a study from January 1987 to January 1990. Sera from 185 hemodialysis and 124 CAPD patients were stored in this period and later analyzed for HBsAg, anti‐HBc, anti‐HBs, and anti‐HCV (second generation ELISA). The prevalence of any HBV marker was 55.7% (103/185) for hemodialysis patients and 31.5% (39/124) for CAPD patients (hemodialysis vs. CAPD, p < 0.001). The prevalence of positive anti‐HCV was 35.1% (65/185) for hemodialysis and 33.9% (42/124) for CAPD patients (not significant). There was a significant association between HBV markers positivity and anti‐HCV positivity. The multivariate analysis of risk factors revealed an association of the positivity of each virus with the duration of renal replacement therapy (RRT), number of previous blood transfusions, and past history of hemodialysis treatment. Thus, besides the transfusion‐related transmission, hemodialysis environmental transmission may also occur for both viruses. The findings of a high prevalence of both viruses and evidence for environmental transmission in the dialysis setting are of major importance for the planning of future preventive measures.
Hepatitis B
Hepatitis C
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Hepatitis C virus infection (HCV) is an important cause of morbidity and mortality in patients with end-stage renal disease (ESRD).In this prospective, observational study, 205 patients, 37 (18%) of them with chronic HCV infection, were followed up for a one-year period at Department of Hemodialysis, Sarajevo Clinical Center, University of Sarajevo. The following parameters were analyzed: dialysis duration, sex, PCR RNA, HCV genotypes and biochemical parameters. Thirteen anti-HCV PCR RNA positive patients were treated with pegylated interferon alpha (Pegasys, Hoffman-La Roche). The goal of therapy was to reach sustained virologic response. The presence of anti-HCV antibodies in serum was detected by enzyme linked immunosorbent assay (ELISA).Of 37 anti-HCV positive patients, there were 20 (54%) males and 17 (45.9%) females with the mean hemodialysis duration of 143.67 +/- 57.64 months and mean age of 54.45 +/- 8.93 years. Of 37 anti-HCV positive patients, 30 (81.08%) patients were HCV RNA PCR positive. Among HCV RNA PCR positive patients, two had up to twofold elevated ALT values, one had twofold elevated AST values, and one had sixfold elevated GGT values. Thirteen RNA PCR positive patients were treated with pegylated interferon alfa for 48 weeks. Only one patient had genotype 1 virus. Upon therapy completion, only three patients were negative by PCR RNA (genotype 1b, 23.07%) at six months and yearly follow ups remained PCR negative.Sustained virologic response was achieved in three study patients. Monitoring guidelines for infection control, isolation of seropositive patients, and strict hygienic preventive measures can prevent HCV seroconversion in hemodialysis patients.
Pegylated interferon
Hepatitis C
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Hepatitis C
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The prevalence of hepatitis C virus (HCV) infection in hemodialysis patients is notably greater than in the general population. Two new reports now
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Rindl, P; Lippi, A; Caprloli, R; Favilla, G; Palmarini, D; Baronti, R; Vatteroni, M. L; Maggi, F; Cioni, L Author Information
Hepatitis virus
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Hepatitis C
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Background
Hepatitis C infection (HCV) is an important problem among hemodialysis and renal transplantation patients. It has been showed that HCV infection is closely associated with mixed type criyoglobulinemia, despite this close relationship, the correlation of HCV and essential mixed criyoglobulinemia has been analysed in a very limited number of studies in hemodialysed and renal transplant patients.Objectives
In this study, we aimed to investigate the prevalence of criyoglobulinemia in HCV positive hemodialysis patients, renal transplant patients and in patients with chronic liver disease in Turkey which type I HCV is the dominant form.Methods
Criyoglobulinemia was studied in 41 hemodialysis, 10 renal transplant and 17 chronic liver disease patients with HCV infection. Anti-HCV antibodies were detected by second and third generation ELISA and for criyoglobulins centrifugation and cold incubation techniques were used.Results
None of the HCV positive hemodialysis and renal transplant patients were found to have criyoglobulinemia, on the other hand criyoglobulinemia was present in only one patient with HCV positive chronic liver disease.Conclusion
Type I HCV is the most common hepatitis C virus type in our hemodialysis unit and in Turkey, so this low prevalence of criyoglobulinemia may be associated with the genotype of HCV and the differences of the geographic areas.Hepatitis C
Liver disease
Chronic liver disease
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HCV infection represents the major cause of chronic liver disease in hemodialysis and renal transplant patients. The clinical course of liver disease in hemodialysis patients is generally asymptomatic. Only few studies describe the natural history of HCV infection in haemodialysis patients, showing an association between HCV infections and poor survival.A prospective cohort study of our haemodialysis population was conducted to define the natural history of HCV infection and its relation to mortality. 77 patients on haemodialysis were enrolled, 24 (31%) of whom were anti-HCV and 53 (69%) anti-HCV-negative.The HCV-RNA was positive in 18 of the 24 anti-HCV-positive subjects (75%). None of the anti-HCV-negative subjects was HCV-RNA-positive. Eight of the 18 HCV-RNA-positive patients (40%) developed cirrhosis with portal hypertension and ascites within 7 years after the first increase of GPT. Seven of these died, nobody developed hepatocarcinoma (HCC). During 58+/-37-follow-up months mortality rate was higher among anti-HCV-positive patients than among anti-HCV-negative. Besides, the 6 deaths occurred only among anti-HCV-positive and HCV-RNA-positive patients.in our haemodialysis patient population the presence of antibodies anti-HCV and HCV-RNA is associated with an increased risk of developing liver cirrhosis and of death, in comparison to anti-HCV-negative patients. Our data show that anti-HCV-positive patients have an accelerated course towards chronic hepatopathy and cirrhosis.
Hepatitis C
Liver disease
Chronic liver disease
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