Hepatitis C, HCV genotypes and hepatic siderosis in patients with chronic renal failure on haemodialysis in Brazil

Farah, Kátia de Paula; Carmo, Ricardo Andrade; Antunes, Carlos Maurício de Figueiredo; Serufo, José Carlos; Júnior, Vandack Alencar Nobre; Castro, Lúcia Porto Fonseca de; Leite, Virgínia Hora Rios; Silva, Rogério Augusto Pinto; Álvares, Maria Carolina Barbosa; Corrêa, Guilherme Oliveira; Busek, Solange Cristina Uber; Lambertucci, José Roberto

doi:10.1093/ndt/gfm028

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…The frequency and severity of complications of liver biopsy in patients with renal failure has been documented. [11][12][13] Therefore, HA levels may be used to defi ne when treatment for hepatitis C should be considered, especially in subjects with coagulation dysfunction caused by renal failure. Besides, it may be used as a screening test before a decision in favor of liver biopsy is to be presented to the patient.…”

Section: Discussionmentioning

confidence: 99%

“…From May 2000 to October 2007, 69 patients with chronic hepatitis C and ESRD on HD who underwent liver biopsy in a previous study 13 were registered under our care. Among those subjects, all individuals who had stored plasma sample (used in HCV-RNA detection) and liver fragments collected within one year by liver biopsy were considered for enrollment.…”

Section: Methodsmentioning

confidence: 99%

“…11,12 In a recent study, severe complications of liver biopsies were demonstrated in 13.2% of HD patients. 13 Therefore, there is a need to assess the utility of noninvasive markers of fibrosis in this population.…”

Section: Introductionmentioning

confidence: 99%

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Hyaluronic acid in the evaluation of liver fibrosis in patients with hepatitis C on haemodialysis

Ávila¹,

Carmo²,

Farah³

et al. 2010

Braz J Infect Dis

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Background: This study evaluated the role of HA as a marker of liver fi brosis in patients with hepatitis C on haemodialysis. Methods: This is a cross-sectional study in which 52 patients were divided into two groups: Group 1: patients with hepatitis C and end-stage renal disease (ESRD) undergoing haemodialysis (n = 23); and Group 2: patients with hepatitis C without ESRD (n = 29). Plasma levels of HA were associated with histological data of the samples obtained by liver biopsy and classifi ed by METAVIR group scoring system. Results: Higher plasma levels were signifi cantly correlated to signifi cant liver fi brosis (METAVIR ≥ F2). In Group 1, the HA cutoff to discriminate signifi cant fi brosis was 984.8 ng/mL, with accuracy, sensitivity and specifi city of 80.8%, 83.0%, and 70.0%, respectively. In Group 2, the HA cutoff was 222.3 ng/mL, with accuracy, sensitivity and specifi city of 74.5%, 70.0%, and 94.0%, respectively. Conclusion: HA was an accurate noninvasive marker in predicting signifi cant fi brosis in patients with hepatitis C on haemodialysis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Hyaluronic acid in the evaluation of liver fibrosis in patients with hepatitis C on haemodialysis

Ávila¹,

Carmo²,

Farah³

et al. 2010

Braz J Infect Dis

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“…It is recommended that the viral load should be determined prior to hemodialysis to avoid the possibility of underestimation. Although the distribution of HCV genotypes varies widely among different geographic regions, HCV genotypes 1 and 2 predominate in ESRD patients with chronic hepatitis C, regardless of geographic areas 73–76 …”

Section: Diagnosis and Evaluation Of Hcv Infection In Esrd Patientsmentioning

confidence: 99%

“…Although the distribution of HCV genotypes varies widely among different geographic regions, HCV genotypes 1 and 2 predominate in ESRD patients with chronic hepatitis C, regardless of geographic areas. [73][74][75][76]…”

Section: Serological Assaysmentioning

confidence: 99%

Treatment of hepatitis C virus infection in patients with end‐stage renal disease

Liu

Kao

2011

J of Gastro and Hepatol

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Hepatitis C virus (HCV) infection is a major health problem in patients with end-stage renal disease (ESRD). The incidence of acute HCV infection during maintenance dialysis is much higher than that in the general population because of the risk of nosocomial transmission. Following acute HCV infection, most patients develop chronic HCV infection, and a significant proportion develop chronic hepatitis, cirrhosis, and even hepatocellular carcinoma. Overall, chronic hepatitis C patients on hemodialysis bear an increased risk of liver-related morbidity and mortality, either during dialysis or after renal transplantation. Interferon (IFN) therapy is modestly effective for the treatment of HCV infection in ESRD patients. Conventional or pegylated IFN monotherapy has been used to treat acute hepatitis C in ESRD patients with excellent safety and efficacy. Regarding chronic hepatitis C, approximately one-third of patients can achieve a sustained virological response (SVR) after conventional or pegylated IFN monotherapy. The combination of low-dose ribavirin and conventional or pegylated IFN has further improved the SVR rate in treatment-naïve or retreated ESRD patients in clinical trials. Similar to the treatment of patients with normal renal function, baseline and on-treatment HCV virokinetics are useful to guide optimized therapy in ESRD patients. Of particular note, IFN-based therapy is not recommended at the post-renal transplantation stage because of the low SVR rate and risk of acute graft rejection. In conclusion, ESRD patients with HCV infection should be encouraged to receive antiviral therapy, and those who achieve an SVR usually have long-term, durable, virological, biochemical, and histological responses.

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Prevalence of hepatitis C virus infection and genotypes in patient with chronic kidney disease undergoing hemodialysis

et al. 2013

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The prevalence of antibodies to HCV varies among Brazilian regions at rates of 8-16%. Since this virus is transmitted by the parenteral route through blood and blood products, patients receiving maintenance hemodialysis therapy are at an increased risk of infection. The study was conducted in seven dialysis centers in Belém, Pará, northern Brazil. Blood samples were collected from 798 patients with chronic renal disease treated by hemodialysis. The samples were tested for antibodies against HCV and the viral genotype was identified. Sixty-seven (8.4%) of the 798 patients studied were anti-HCV positive by ELISA, ranging from 4% to 14% in different centers. Viral RNA was detected in 5.3% (43/798) of the patients; of these, 42 also had anti-HCV antibodies. HCV genotyping revealed genotype 1 as the most common, detected in 86.1% (37/43) of the patients, followed by genotype 2 in 11.6% (5/43) and genotype 3 in one patient (2.3%). The findings of this study highlight the importance of control strategies for hepatitis C in hemodialysis patients. Molecular biology methods need to be available in these centers to screen for HCV on admission in order to establish effective infection control measures.

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Hepatitis C, HCV genotypes and hepatic siderosis in patients with chronic renal failure on haemodialysis in Brazil

Cited by 13 publications

References 17 publications

Hyaluronic acid in the evaluation of liver fibrosis in patients with hepatitis C on haemodialysis

Hyaluronic acid in the evaluation of liver fibrosis in patients with hepatitis C on haemodialysis

Treatment of hepatitis C virus infection in patients with end‐stage renal disease

Prevalence of hepatitis C virus infection and genotypes in patient with chronic kidney disease undergoing hemodialysis

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