Changes in viremia and circulating interferon-α during hemodialysis in hepatitis C virus-positive patients: only coincidental phenomena?

Badalamenti, Salvatore; Catania, Anna; Lunghi, G.; Covini, Giovanni; Bredi, Elena; Brancaccio, Diego; Salvadori, Maurizio; Como, Giovanna; Ponticelli, Claudio; Graziani, G.

doi:10.1016/s0272-6386(03)00417-7

Cited by 61 publications

(37 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…61 Several biological mechanisms may be responsible for the relatively high response to interferon in dialysis patients in spite of immune compromise due to uremia. Haemodialysis patients with HCV have a low viral load 62 Interferon could help to restore the cell-mediated immunity depressed by uremia; an increase of endogenous interferon activity during haemodialysis sessions has been shown recently 63 HCV-related liver disease shows frequently mild histopathological features in haemodialysis patients. 62 Importantly, clearance of interferon is lower in dialysis than in non-uremic patients.…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

View full text Add to dashboard Cite

SUMMARYBackground: The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. Methods and aims: We evaluated the efficacy and safety of initial interferon monotherapy 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 (as a measure of efficacy); 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. Results: We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop-out rate was 37% [95% confidence interval (CI) 28-48] and 17% (95% CI 10-28),

show abstract

Section: Discussionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

View full text Add to dashboard Cite

show abstract

“…Several studies reported the disease activity in HCV-infected HD patients to be mild to moderate and usually milder than non-HD patients [106, 107,117,118,119]. There are several explanations for less liver damage in HD than non-HD HCV-infected patients, including: (a) the altered immunologic state of the patients on HD; (b) a relatively low HCV viral load in the HD population with HCV infection [120] probably secondary to the clearance of HCV RNA by the dialysate and/or the entrapment of HCV RNA particles onto the membrane surface of dialyzers; (c) marked and prolonged hepatocyte growth factor release in HD compared to non-HD HCV-infected subjects [117] based on the suggested acceleration in liver regeneration by exogenous hepatocyte growth factor administration in animal studies, and (d) marked endogenous interferon-α increment after HD using both cellulosic and synthetic membranes [121], which may reduce HCV viremia.…”

Section: Natural History and Liver Histopathology In Hcv-infected Hd mentioning

confidence: 99%

Hepatitis C in Hemodialysis Patients: Current Global Magnitude, Natural History, Diagnostic Difficulties, and Preventive Measures

2008

View full text Add to dashboard Cite

Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in hemodialysis (HD) patients. The reported prevalence of HCV among the HD population has varied greatly from 1.9 to 84.6% in different countries in recent years. The length of time on HD is generally believed to be associated with HCV acquisition in HD subjects. Nevertheless, several recent reports failed to recognize any significant role of blood transfusion. Although there are some considerations about the accuracy of serologic testing in detecting HCV in HD patients, the accumulated data in this review suggest the false-negativity rate to be not more than 1.66% (153/9,220). Therefore, substituting virologic for serologic testing in the routine diagnosis of HCV infection in HD patients seems unreasonable. Several phylogenetic analyzes of viral isolates suggested nosocomial patient-to-patient transmission of HCV among HD patients for which the main potential source is believed to be contaminated hands and articles. However, isolation of HCV-infected HD patients and use of dedicated machines are currently unjustified while strict adherence to universal precautions seems to be enough to control disease spread in HD units. The present article is an update on epidemiological and clinical features of HCV in HD population.

show abstract

“…The intradialytic changes in IFN-α levels reported in anti-HCV positive patients and thought to be associated with the HCV viral load [25] were not seen in our cohort of HBV-infected patients. We found an increase in IFN-α in a minority of HD procedures only (7.5%); and no relationship between reduction of HBV viral load and intradialytic kinetics of IFN-α occurred.…”

Section: Discussionmentioning

confidence: 56%

“…Various mechanisms have been cited including clearance of HBV viremia during hemodialysis sessions [22,23] or peritoneal dialysis treatment [24]. The intradialytic production of interferon (IFN) [25] or other protective substances [26] has been advocated for HCV-infected patients on intermittent dialysis.…”

Section: Introductionmentioning

confidence: 99%

Kinetics of Hepatitis B Virus Load During Haemodialysis Sessions and α-Interferon: A Prospective Study

Fabrizi¹,

Lunghi

Alongi³

et al. 2013

Kidney Blood Press Res

Self Cite

View full text Add to dashboard Cite

Background: It has been reported a slow progression of hepatitis B in patients undergoing maintenance dialysis, and a role of dialysis session per se has been suggested. The aim of the present study is to evaluate the kinetics of the hepatitis B viral load (HBV DNA) in serum during haemodialysis sessions using a highly sensitive technique; the role of interferon-α in lowering HBV viral load in such patients was also investigated. Methods: HBV DNA was determined in 24 HBsAg positive patients on maintenance hemodialysis immediately before and after a 4-hour hemodialysis session, the same measurements were repeated 48 and 72 hours later. HBV DNA quantitation was performed by a novel RealTime PCR assay. Serum IFN-α levels were tested in parallel in a subset of HD sessions (n=40) by ELISA. Results: 20 (83%) HBsAg positive patients had detectable HBV DNA in serum. Positive status for HBV DNA in serum was not predicted by demographic, clinical or biochemical parameters. HBV load decreased in many patients after hemodialysis sessions 5.92 log₁₀ IU/mL (95% CI, 5.34 to 6.28 log₁₀ IU/mL) vs. 4.79 log₁₀ IU/mL (95% CI, 4.23 to 6.15 log₁₀ IU/mL) (P=0.02). A significant relationship between mean HBV DNA levels before dialysis and percentage reduction of HBV DNA during HD sessions occurred [F-test=5.41, rho (least squares)=0.307]. Increase of serum IFN-α levels was found in a minority (3/40=7%) of HD sessions. Conclusions: Hemodialysis procedure gives reduction of HBV load in HBsAg chronic carriers; no relationship with IFN-α activity during HD sessions was found. The kinetics of HBV viremia in HD procedures could explain the low viral load which is typically observed in these patients. Further studies to identify the mechanisms responsible for reduction of HBV viremia during HD procedures are under way.

show abstract

Changes in viremia and circulating interferon-α during hemodialysis in hepatitis C virus-positive patients: only coincidental phenomena?

Cited by 61 publications

References 35 publications

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Hepatitis C in Hemodialysis Patients: Current Global Magnitude, Natural History, Diagnostic Difficulties, and Preventive Measures

Kinetics of Hepatitis B Virus Load During Haemodialysis Sessions and α-Interferon: A Prospective Study

Contact Info

Product

Resources

About