Trends of treated hepatitis B, hepatitis C, and tuberculosis infection in long-term hemodialysis patients in Taiwan: A nationwide survey in 2010–2018

Lee, Jia-Jung; Chang, Jer‐Ming; Yang, Li‐Chin; Hsu, Chih‐Cheng; Lin, Ming‐Hsien; Lin, Ming‐Yen

doi:10.1016/j.jfma.2021.12.019

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…Reasons are likely multifactorial for the low level of antiviral treatment of HCV+ patients in practice among the DOPPS 7-China HD units, but we suspect the main factor is the high cost of DAAs accompanied by lack of reimbursement by the national insurance system during this study time period ( 12 ). A similar situation occurred in Taiwan, where DAAs were approved for use in 2015, but the number of patients receiving DAAs treatment was very limited until 2018 due to medical insurance reimbursement policy ( 13 ). In our study, HCV+ patients were referred to a liver/gastroenterology specialist in 85% of HD units.…”

Section: Discussionmentioning

confidence: 89%

Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21)

et al. 2022

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BackgroundPrior work from the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed HCV prevalence in China in 2012–2015 being in the upper third and HCV incidence the 2nd highest among 15 different countries/regions investigated. The goal of the present investigation was to: (1) determine if HCV prevalence and incidence has changed, and (2) collect detailed data to understand how HCV is treated, monitored, and managed in Chinese HD facilities and non-dialysis chronic kidney disease (CKD) clinics.Data and MethodsDetailed data for 1,700 randomly selected HD patients were reported by 39 randomly selected HD facilities from Beijing, Shanghai, and Guangzhou participating in the DOPPS 7-China study from 2019 to 2021. The study site medical directors completed a survey regarding numerous aspects of HCV treatment and management in HD and ND-CKD patients.ResultsIn this 2019 to 2021 cohort, HCV prevalence was 7.4%, which was lower than the 14.8 and 11.5% HCV prevalence for the 2009–2011 and 2012–2015 cohorts, respectively. HCV incidence of 1.2 cases per 100 pt-yrs also was lower compared to the incidence of 2.1 for the 2012–2015 cohort. Although the great majority of study site medical directors indicated that all or nearly HCV+ patients should be treated for their HCV, very few HCV+ patients have been treated presumably due to substantial cost barriers for affording the new direct acting antivirals (DAAs). The randomly selected facilities in our DOPPS 7-China study appear to have excellent programs in place for frequent monitoring of patients and staff for HCV, education of staff, and referral of HCV cases to external infectious disease, gastroenterology, and liver disease specialists. Liver biopsies were not commonly performed in HCV+ HD patients. HCV genotyping also was rarely performed in participating units.ConclusionsOur study indicates a 50% decline in HCV prevalence and a >40% decline in HCV incidence in Chinese HD patients over the past 10–12 yrs. Chinese HD facilities and associated specialists appear to be well-equipped and organized for successfully treating and managing their HCV+ HD and CKD patients in order to achieve the WHO goal of eliminating HCV by 2030.

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Section: Discussionmentioning

confidence: 89%

Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21)

et al. 2022

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“…With the implementation of the directly observed treatment strategy (DOTS) program, the mortality and new case decreased in recent years. [ 6 , 7 ] Nowadays, more than 85% of TB cases could be cured. However, adverse effects including DILI, drug eruptions, gastrointestinal or neurological disorders dampened the completion of anti-TB medications, in which DILI accounts for at least 11% of discontinuation of anti-TB drugs.…”

Section: Discussionmentioning

confidence: 99%

Pyrazinamide related prolonged drug-induced liver injury: A case report

Wang

Chen

et al. 2022

Medicine

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Rationale: Drug induced liver injury (DILI) is a common side effect causing treatment discontinuation during tuberculosis (TB) treatment, and pyrazinamide (PZA) usually leads to a delayed and prolonged abnormal liver function of the 4 standard anti-tuberculosis regimens. However, a prolonged hepatitis lasting more than 4 months is rarely reported. Patient concerns: A 78-year-old man presented with general weakness and poor appetite on his seventh week of anti-TB treatment for tuberculosis lymphadenitis. Diagnosis: Drug induced liver injury, PZA-related. NAT2 slow acetylator phenotype was accidentally found during workup of DILI. Intervention: A liver biopsy was performed and PZA-related DILI was suspected. All anti-TB medications were therefore discontinued. Outcome: After withholding all anti-TB medications for 4 months, the elevations of aminotransferases and hyperbilirubinemia completely resolved. Anti-TB therapy was switched to ethambutol and levofloxacin for 15 months without adverse events. Long-term ultrasound follow-up was performed and cervical lymphadenopathy completely resolved. Conclusion: Our patient presents with PZA related prolonged DILI resolved after drug discontinuation for 4 months. NAT2 slow acetylator phenotype may be related to this condition through unknown mechanisms.

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“…10,[15][16][17] Incidence and prevalence, 18 mortality, 19 kidney transplantation, 20 medication, 21 hospitalizations, 22 healthcare utilization and expenditure, 23 unrecovered incident dialysis, 24 pre-ESRD care program, 27 and hepatitis virus tuberculosis therapy. 11 3. Effectiveness of universal payfor-performance programs for CKD care.…”

Section: Subjectmentioning

confidence: 99%

“…The TWRDS has worked with the Taiwan government to monitor direct-acting antiviral therapy in the dialysis population with hepatitis C virus infection to progress toward hepatitis C virus elimination by 2030. 11,34 Although the TWRDS offers rich resources for mapping kidney disease-relevant journeys, it is worth considering that data beyond the traditional collection approaches may bring new care applications, such as portable devices like smartphones. The collection of real-time information at home could assist in developing a warning transport system or expert decision support system to construct a more holistic kidney prevention and care network.…”

Section: New Cornersmentioning

confidence: 99%

Taiwan renal data report system: Framework, function, and development

Lin,

Liao,

Lin

et al. 2023

Nephrology

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The world healthcare system is actively seeking possible solutions for the rapid growth of kidney disease threats. The Taiwan Renal Data System (TWRDS) was central in assisting kidney health and care policymaking to reduce end‐stage kidney disease incidence and mortality. This article summarizes the TWRDS framework, recent applications, and developments to provide new insights for some international researchers to promote planetary kidney health. The TWRDS originated in 1987 for the accreditation and quality monitoring of dialysis units and was connected with enriched health claim databases after the implementation of universal national health insurance in Taiwan in 1995. As a healthcare information centre, TWRDS has published annual reports forming indispensable instructions for renal care improvement since 2014. The TWRDS possesses three main functions: (1) kidney disease surveillance; (2) offering rich materials for research purposes; (3) achieving precision prevention and care through complex algorithms. In the new era, TWRDS can help build a more resilient society against communicable disease threats by integrating remote sensor techniques for developing future remote healthcare structures, as well as identifying kidney health inequity populations and promoting healthcare resources distributed equity. The global healthcare system is facing escalating burdens of non‐communicable disease care due to the rapidly growing elderly population. Therefore, a considerable‐scale data system is an essential decision‐supportive tool in promoting an evidence‐based, resilient, sustainable, equity care environment. Undoubtedly, TWRDS experience is a practical example of leveraging healthcare providers' decisions, care outcomes, and renovation.

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Trends of treated hepatitis B, hepatitis C, and tuberculosis infection in long-term hemodialysis patients in Taiwan: A nationwide survey in 2010–2018

Cited by 8 publications

References 24 publications

Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21)

Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21)

Pyrazinamide related prolonged drug-induced liver injury: A case report

Taiwan renal data report system: Framework, function, and development

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