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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Utilization of Signal-to-Cutoff Ratio of Hepatitis C Virus Antibody Assay in Predicting HCV Viremia among Hemodialysis Patients.

      Author(s): 1 , , , ,
      Publication date (Electronic):
      Journal: Nephron
      Publisher: S. Karger AG

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          Abstract

          Hepatitis C virus (HCV) infection is a common cause of acute and chronic hepatitis among the hemodialysis population. To prevent cross infection between hemodialysis patients during the hemodialysis procedure, routine screening of anti-HCV antibody is recommended. However, a reactive anti-HCV EIA test is not equal to active HCV infection. An expensive RT-PCR study is required to confirm HCV viremia. This will significantly increase the cost burden because payment for each hemodialysis treatment is very low in Taiwan. Thus, it is useful to identify parameters that could predict HCV viremia among anti-HCV-reactive patients. In this study, we examined the usefulness of signal-to-cut (S/CO) ratio of anti-HCV antibody in discriminating HCV viremia from non-viremia among the anti-HCV-reactive hemodialysis population.

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          The prevalence of hepatitis C virus infection in the United States, 1988 through 1994.

          Miriam J Alter, Deanna Kruszon-Moran, Omana Nainan … (1999)
          Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts. We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing. The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection. In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection.
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            Hepatitis C infection and the patient with end-stage renal disease.

            Fabrizio Fabrizi, F Poordad, Paul Martin Putora (2002)
            Hepatitis C virus (HCV) remains common in patients with end-stage renal disease (ESRD) and is an important cause of liver disease in this population. Acquisition of HCV infection continues to occur in dialysis patients because of nosocomial spread. The natural history of HCV in dialysis patients remains controversial because the course of HCV typically extends over decades, whereas dialysis patients have higher morbidity and mortality rates than those of the general population limiting long-term follow-up. However, recent reports suggest that HCV infection affects the survival of chronic dialysis patients as well as renal transplant (RT) recipients. The severity of preexisting liver disease on pretransplantation liver biopsy may provide useful prognostic information about clinical outcome after RT; liver biopsy should be incorporated in the evaluation and management of RT candidates with HCV. Recent surveys with long-term follow-up have documented adverse effects of HCV on patient and graft survival. Use of renal grafts from HCV-infected donors in recipients with HCV does not appear to result in a greater burden of liver disease albeit with short-term follow-up. There is only limited data about interferon (IFN) therapy in chronic dialysis patients, although sustained responses are reported. Preliminary data on IFN plus ribavirin therapy in dialysis patients with hepatitis C have given encouraging results, but randomized trials are needed. Interferon remains contraindicated post-RT because of concern about precipitating graft dysfunction.
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              The natural history of hepatitis C.

              Nezam Afdhal (2004)
              Hepatitis C virus (HCV) is the most common cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC) in the United States and infects an estimated 170 million people worldwide. In the United States, overall hepatitis C prevalence is 1.8% and is higher in African Americans and Hispanics than it is in white Americans. The age distribution places 65% of all subjects with anti-HCV antibodies between 30 and 49 years of age. Before serological screening of blood products was initiated, hepatitis C was most commonly transmitted by transfusion of contaminated blood products, but now it is acquired primarily via intravenous drug use. Only 10 to 25% of infected adult patients spontaneously resolve their infection, and the remaining 75% remain persistently viremic and often asymptomatic. Progression of liver disease in 20 to 30% of patients can lead to compensated and eventually decompensated cirrhosis or hepatocellular carcinoma, or both. This article looks briefly at the epidemiology and natural history of hepatitis C.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Nephron
                Title: Nephron
                Publisher: S. Karger AG
                ISSN (Electronic): 2235-3186
                ISSN (Print): 1660-8151
                Publication date (Electronic): 2015
                Volume: 130
                Issue: 2
                Affiliations
                [1 ] Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
                Article
                Publisher Item ID: 000430988
                DOI: 10.1159/000430988
                PubMed ID: 26065912
                SO-VID: 19142a77-b0c3-40f8-a642-ece1889f865f
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