Acute Hepatitis C in Patients Receiving Hemodialysis
- 1 January 2007
- journal article
- Published by Taylor & Francis in Renal Failure
- Vol. 29 (6), 731-736
- https://doi.org/10.1080/08860220701460160
Abstract
Hepatitis C virus (HCV) infection is frequent in patients with end-stage renal disease treated by chronic dialysis, with a prevalence varying from 10-65% according to the geographical data. The prevalence is significantly associated with the duration of dialysis and the number of transfused blood products[1,2] and has dramatically declined with efficient blood screening.[3] We studied patients with acute HCV infection in a dialysis unit. The diagnosis was based on both anti-HCV detection and HCV-RNA detection. Other virological tools including HCV genotype determination was also used to tailor treatment to the individual patient and determine its efficacy for a one-year follow-up period. Seventeen patients (7 male and 10 female, mean age: 63.7 +/- 11.6 SD) with acute hepatitis C were enrolled to our study. All of them were followed up for a period of one year after the diagnosis was established. Phylogenetic analysis distinguished two separate HCV subtypes 1b, which were both responsible for this acute infection (see Figure 1). These types did not differ in their behavior on the clinical situation of our patients, as confirmed by the fact that in both groups of patients, there was only one patient who presented with acute illness. Six patients of our study group, three months after the acute infection, received pegylated interferon (Peg-IFNa2a) 135 mug for a six-month period. Four of them responded very well to therapy and at the first determination HCV RNA was below the cutoff point. One of our patients with very high HCV levels (HCV RNA > 50,000,000 IU/mL), despite receiving the same therapy, did not respond well and developed cirrhosis. In conclusion, it is clear from our experience that better information is needed about the current incidence, prevalence, and risk factors for HCV infection in dialysis patients. Algorithms for the diagnosis and management of hepatitis C should be developed by academic societies. Routine screening for hepatitis C also would allow for better definition of the natural history of hepatitis C in patients with end stage renal disease. [image omitted]Figure 1. NS 5B gene phylogenetic tree analysis of the acute hepatitis C epidemic.Keywords
This publication has 11 references indexed in Scilit:
- Hepatitis C and renal disease: an updateAmerican Journal of Kidney Diseases, 2003
- Therapy for Acute Hepatitis CNew England Journal of Medicine, 2001
- Universal precautions prevent hepatitis C virus transmission: A 54 month follow-up of the Belgian multicenter studyKidney International, 1998
- Risk of hepatitis C seroconversion after occupational exposures in health care workers*1American Journal of Infection Control, 1995
- HLA DPB polymorphism in primary sclerosing cholangitis and primary biliary cirrhosisHepatology, 1995
- High prevalence of a rare hepatitis C virus in patients treated in the same hemodialysis unit: Evidence for nosocomial transmission of HCVKidney International, 1995
- Genetic Heterogeneity of Hepatitis C Virus: Quasispecies and GenotypesSeminars in Liver Disease, 1995
- Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients: A Longitudinal Study Comparing the Results of RNA and Antibody AssaysHepatology, 1993
- The Declining Risk of Post-Transfusion Hepatitis C Virus InfectionNew England Journal of Medicine, 1992
- The Prevalence of Hepatitis C Virus Antibodies among Hemodialysis PatientsAnnals of Internal Medicine, 1990