Hemodialysis prevents liver disease caused by hepatitis C virus: Role of hepatocyte growth factor

Rampino, Teresa; Arbustini, Eloisa; Gregorini, Marilena; Guallini, Paola; Libetta, Carmelo; Maggio, Milena; Silini, Enrico Maria; Soccio, Grazia; Canton, Antonio Dal

doi:10.1046/j.1523-1755.1999.00791.x

Cited by 84 publications

(59 citation statements)

References 37 publications

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“…[10][11][12][13][14][15] The vague clinical picture and the fluctuating pattern of symptoms in dialysis patients with hepatitis often make the diagnosis of CHC infection difficult or even impossible if based only on clinical conditions. Although liver biochemical tests among dialysis patients were formerly considered a poor indicator of CHC infection, and normal ALT levels cannot exclude viral hepatitis because HD patients have depressed serum ALT at baseline, [17,18,[26][27][28] a relatively increased serum AST and ALT concentration, even under conventional normal limits, was still discovered among majority of chronic HD patients with CHC when compared with hepatitis-free patients, as shown in some recent publications. [15][16][17] Liver function test remained one of the initial convenient screening tests checked monthly and regularly for HD subjects with asymptomatic hepatitis.…”

Section: Discussionmentioning

confidence: 99%

“…[18,26,27] Many unidentified variables to cause a lower level of liver enzymes may require further investigation. With a reduction in the cutoff value of ALT to half of that previously established, [15,28,29] which is close to our results, more and more evidence was demonstrated that CHC activity in HD patients, when corrected for low ALT/AST, can still differ from that in normal controls.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Hepatitis C Virus on Hemoglobin and Hematocrit Levels in Saudi Hemodialysis Patients

2009

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Background. Hepatitis C virus infection is common among patients undergoing hemodialysis, and HD patients are at high risk for infection with such virus. Recently, some studies and case reports indicated attenuated anemia in HD patients with HCV infection, and they previously considered this to be related to increased erythropoietin production after hepatic stimulation by chronic infection with hepatitis virus. Aim. The aim of our study is to investigate whether HCV-positive HD patients have higher hemoglobin (Hb) and hematocrit (HCT) values compared to HCV-negative patients. Methods. We retrospectively studied 83 chronic HD patients from Prince Salman Center for Kidney Disease, and monthly samples were collected between July 2007 and July 2008. The HCV status was determined by anti-HCV antibodies and confirmed with RNA polymerase chain reaction (PCR). Those with a history of blood transfusion or massive blood loss during the last six months were excluded from the study. Results. Thirty-three percent of our patients tested positive for anti-HCV antibody (51.8% were male). The mean age for HCV-positive group was 54.92 ± 15.61 years, while it was 51.01 ± 14.81 years for the HCV-negative group (p = 0.27). Mean Hb in the HCV-positive group was 11.18 ± 1.41gm/dL compared to 10.87 ± 1.29 gm/dL for the HCVnegative group (p = 0.05). Mean HTC values for the HCVpositive group was 34.4 ± 3.9, compared to 32.41 ± 3.41 for the HCV-negative group 12 months after starting hemodialysis. Eighty-one patients (27 HCV-positive and 54 HCVnegative) received erythropoietin (EPO) therapy. Seventytwo patients (25 HCV-positive and 47 HCV-negative) received IV iron (p = 0.28). Mean erythropoietin dose was (114.83 ± 84.92 IU/kg/week) for HCV-positive compared to (122.2 ± 91.46 IU/kg/week) for HCV-negative group (p = 0.74). Liver function tests were normal except for higher bilirubin level in the HCV-positive group, 7.74 ± 4.03 Umol/L compared to 5.47 ± 3.71 Umol/L in the HCV-negative group (p = 0.01). Conclusion. Our study showed that ESRD patients on HD with HCV infection have higher Hb and HCT levels compared with HCV-negative patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Hepatitis C Virus on Hemoglobin and Hematocrit Levels in Saudi Hemodialysis Patients

2009

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“…The dysfunction of B and T cells (23,24), elevated levels of hepatocyte growth factor (25), and changes in the antioxidant system in the serum of HD patients (26) are factors that may be associated with lower liver inflammation. Regardless of the reasons, lower liver inflammation in HD patients may contribute to a delay in the progression of liver disease because the rate of inflammatory activity is associated with fibrosis progression (27).…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Is Less Aggressive in Hemodialysis Patients than in Nonuremic Patients

Trevizoli

Menezes²,

Velasco³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: The severity of liver disease among hepatitis C patients on hemodialysis is controversial. The aim of this study was to compare the clinical, biochemical, and liver histologic characteristics of hepatitis C virus (HCV) in hemodialysis patients and in those with normal renal function.Design, setting, participants, & measurements: A case-control study was carried out with 36 HCV patients on hemodialysis and 37 HCV patients with normal renal function matched for gender, age at infection, and estimated time of infection.Results: HCV patients on hemodialysis had lower levels of alanina aminotransferase and lower viral load. Hepatic fibrosis was significantly higher in the patients with normal renal function (73%) than in hemodialysis patients (47.2%, P < 0.025); the same was observed for inflammatory activity (control group 59.5% versus hemodialysis patients 27.7%, P ‫؍‬ 0.003). In addition, the risk of tissue inflammation was four times lower in hemodialysis patients (odds ratio ‫؍‬ 0.23, P < 0.004), and severe inflammatory activity on biopsy was the only independent risk factor for fibrosis (P < 0.001).Conclusions: The lower biochemical and inflammatory activities observed in hemodialysis patients suggest that hemodialysis and uremia may have a protective role against progression of the disease caused by HCV.

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“…These include the altered immunologic state and relatively low HCV viral load as a result of clearance of HCV RNA by dialysate and/or possible viral clearance by dialyzer surface membranes; in addition, cytokines such as IFN-α and hepatocyte growth factor and antiviral activity may play a role. 12,13 Long-term patient and graft survival rates are lower in anti-HCV-positive than anti-HCVnegative kidney transplant recipients. 14 However, data are contradictory about whether or not the severity of underlying liver disease in patients with HCV has an effect on outcomes after kidney transplant.…”

Section: Discussionmentioning

confidence: 99%

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2015

Exp Clin Transplant

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Objectives: There is no correlation between alanine aminotransferase levels, viral load, and histologic findings at dialysis in patients with chronic hepatitis C virus infection. Identification of the severity of hepatitis C-related liver disease before transplant could provide valuable data about the risk for liverrelated mortality after transplant. In this study, we aimed to identify the severity of liver disease in endstage renal disease patients with chronic hepatitis C virus infection, the progression of hepatic histopathology after kidney transplant, and whether immunosuppressive therapy affected posttransplant viral replication and hepatic histology.

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Hemodialysis prevents liver disease caused by hepatitis C virus: Role of hepatocyte growth factor

Abstract: These results show that HCV-related liver disease is more benign in patients on RDT. The phenomenon may depend on the marked and prolonged HGF release caused by dialysis.

Cited by 84 publications

References 37 publications

Effect of Hepatitis C Virus on Hemoglobin and Hematocrit Levels in Saudi Hemodialysis Patients

Effect of Hepatitis C Virus on Hemoglobin and Hematocrit Levels in Saudi Hemodialysis Patients

Hepatitis C Is Less Aggressive in Hemodialysis Patients than in Nonuremic Patients

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