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Alshwayyat S, Hanifa H, Almasri N, Taimeh Z, Alshwaiyat Y, Khdair T, Alfawares M, Alsaleh B, Assaf N. Hepatitis C virus among hemodialysis patients: burden, risks, and prevention in resource-limited regions. Int Urol Nephrol 2025:10.1007/s11255-025-04555-6. [PMID: 40335857 DOI: 10.1007/s11255-025-04555-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 04/26/2025] [Indexed: 05/09/2025]
Abstract
BACKGROUND Hepatitis C virus (HCV) poses a significant health risk to hemodialysis patients because of their increased susceptibility to infection, especially in resource-limited environments. HCV infection can result in severe complications such as liver failure and higher mortality rates. This study evaluated the prevalence of HCV infection among patients undergoing hemodialysis and identified critical risk factors to enhance targeted prevention strategies. METHODS A cross-sectional, observational study was conducted at Damascus Hospital and Surgical Kidney Hospital between 2017 and 2022 to assess HCV prevalence and associated risk factors in hemodialysis patients. Data included demographics, dialysis duration, dialysis route, history of blood transfusion, liver function test results, and anti-HCV antibody results. Statistical analyses were performed using chi-square tests, ANOVA, and t-tests. RESULTS Of the 200 hemodialysis patients, 24% tested positive for HCV virus. Infection rates were significantly higher in patients with longer dialysis durations (p = 0.001), double-lumen catheter use (32.5% of the sample), and history of blood transfusions (20% of the sample). Patients who primarily underwent AV fistula dialysis showed comparatively lower infection risk. Additionally, demographic factors such as urban residency and older age were observed in a higher proportion of HCV-positive patients, although the difference was not statistically significant. CONCLUSION This study highlighted a significant HCV burden among hemodialysis patients, with infection risk correlating with dialysis duration, blood transfusion history, and catheter type. These findings underscore the need for consistent infection control measures and targeted interventions to reduce HCV transmission and improve patient outcomes, especially in regions with limited healthcare resources.
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Affiliation(s)
- Sakhr Alshwayyat
- Research Associate, King Hussein Cancer Center, Amman, Jordan
- Internship, Princess Basma Teaching Hospital, Irbid, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Hamdah Hanifa
- Faculty of Medicine, University of Kalamoon, Al-Nabk, Syria.
| | | | - Zaid Taimeh
- Internship, Jordanian Royal Medical Services, Amman, Jordan
| | - Yamen Alshwaiyat
- Doctor of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarek Khdair
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Basil Alsaleh
- Faculty of Medicine, Tbilisi State Medical University, Tbilisi, Georgia
| | - Nihad Assaf
- CES De Nephrologie, Associate Professor at the University of Kalamoon, Damascus, Syria
- CES De Nephrologie, Associate Professor at Syrian Private University, Damascus, Syria
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Ratiu IA, Mihaescu A, Olariu N, Ratiu CA, Cristian BG, Ratiu A, Indries M, Fratila S, Dejeu D, Teusdea A, Ganea M, Moisa C, Marc L. Hepatitis C Virus Infection in Hemodialysis Patients in the Era of Direct-Acting Antiviral Treatment: Observational Study and Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:2093. [PMID: 39768975 PMCID: PMC11678887 DOI: 10.3390/medicina60122093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 12/16/2024] [Accepted: 12/18/2024] [Indexed: 01/05/2025]
Abstract
Background and Objectives: Hepatitis C virus (HCV) infection is a major global public health concern, particularly in hemodialysis (HD) patients. This study aims to evaluate the demographic, clinical, and laboratory characteristics of HCV-positive patients undergoing HD and assess the long-term impact of direct-acting antivirals (DAAs) on patient outcomes. Moreover, a narrative review aims to summarize the current knowledge regarding HCV treatment in HD patients. The search in the PubMed, Google Scholar, and Scopus databases identified 48 studies relevant to our topic, 18 regarding clinical history and 29 related to HCV treatment. Methods: A retrospective analysis was performed on 165 HD patients from Bihor County HD centers, Romania, between 2014 and 2024. The cohort was divided into two groups: 54 patients who tested positive for HCV and 111 controls who were HCV-negative. Data collected from GPs included demographic information, comorbidities, laboratory parameters, and psychological assessments. Outcomes were evaluated at over 5 years after DAA treatment. A literature review was conducted using PubMed and Google Scholar to identify relevant studies on HCV in HD patients from 1989 to 2024. Results: Laboratory results showed similar parameters across groups, except for lower serum cholesterol levels in the HCV-positive DAA-treated group vs. HCV-positive non-treated ones (155.607 mg% vs. 170.174 mg%, p = 0.040) and increased ALT levels when comparing the same groups (29.107 vs. 22.261, p = 0.027), whereas comorbidities did not differ significantly. The incidence of malignancies was significantly higher among HCV-positive compared to HCV-negative patients (20.3% vs. 8.1%, p = 0.023), mainly among those treated with DAAs, highlighted by the multivariate analysis. Cardiovascular disease remains the leading cause of mortality regardless of HCV status or the use of antiviral therapy. Psychological assessments revealed more severe depression in HCV-positive patients compared to their HCV-negative counterparts. Conclusions: HCV infection in the hemodialysis population typically follows a subclinical course. At over five years after DAA therapy, the results indicate a stabilization of the liver function and the absence of major complications. However, the incidence of malignancies remains high in HCV-positive patients.
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Affiliation(s)
- Ioana Adela Ratiu
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
- Nephrology Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania
| | - Adelina Mihaescu
- Department of Internal Medicine II—Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.M.); (N.O.); (L.M.)
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Nicu Olariu
- Department of Internal Medicine II—Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.M.); (N.O.); (L.M.)
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Cristian Adrian Ratiu
- Dentistry Department, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania;
| | - Bako Gabriel Cristian
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
- Nephrology Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania
| | - Anamaria Ratiu
- Faculty of Dentistry, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Victor Babeș 8, 400347 Cluj-Napoca, Romania;
| | - Mirela Indries
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
- Infectious Diseases Department, Emergency Clinical Hospital, 410167 Bihor County, Romania
| | - Simona Fratila
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
| | - Danut Dejeu
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
| | - Alin Teusdea
- Faculty of Environmental Protection, University of Oradea, G-ral Magheru 27, 410087 Oradea, Romania;
| | - Mariana Ganea
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
| | - Corina Moisa
- Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania; (I.A.R.); (B.G.C.); (M.I.); (S.F.); (D.D.); (M.G.)
| | - Luciana Marc
- Department of Internal Medicine II—Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.M.); (N.O.); (L.M.)
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Sohal A, Singh C, Bhalla A, Kalsi H, Roytman M. Renal Manifestations of Chronic Hepatitis C: A Review. J Clin Med 2024; 13:5536. [PMID: 39337023 PMCID: PMC11433393 DOI: 10.3390/jcm13185536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 09/13/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Hepatitis C virus (HCV) has emerged as a major global health concern and, if left untreated, can lead to significant liver damage, including cirrhosis, decompensated liver disease, and hepatocellular carcinoma (HCC). Approximately 40% of patients with HCV infection experience extrahepatic manifestations, including renal involvement. HCV-related renal disease is of significant importance among patients with chronic kidney disease (CKD), leading to higher morbidity and mortality. The renal damage due to HCV infection primarily results from cryoglobulinemia and glomerulonephritis, with conditions such as membranoproliferative glomerulonephritis (MPGN) and membranous nephropathy (MN) being most prevalent. Despite advancements in treatment, including the use of directly acting antiviral agents (DAAs), renal complications remain a significant burden in untreated patients. HCV-positive patients on hemodialysis (HD) or those who have undergone kidney transplantation face increased mortality rates compared to their HCV-negative counterparts. Managing HCV infection before kidney transplantation is crucial to mitigate the risk of HCV-related renal complications. Conversely, kidney transplantation from HCV-infected donors is well established, as post-transplant treatment for HCV is safe and effective, potentially reducing mortality and morbidity for patients on transplant waiting lists. This review aims to provide a comprehensive analysis of the renal manifestations of HCV, emphasizing the importance of early diagnosis and treatment to improve patient outcomes.
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Affiliation(s)
- Aalam Sohal
- Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 2500, USA
| | - Carol Singh
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Akshita Bhalla
- Department of Internal Medicine, Punjab Institute of Medical Sciences, Jalandhar 144006, Punjab, India
| | - Harsimran Kalsi
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA
| | - Marina Roytman
- Division of Gastroenterology and Hepatology, University of California San Francisco, Fresno, CA 93701, USA
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Kenfack-Momo R, Ngounoue MD, Kenmoe S, Takuissu GR, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Zeuko’o Menkem E, Lontuo Fogang R, Tchatchouang S, Ndzie Ondigui JL, Kame-Ngasse GI, Kenfack-Zanguim J, Magoudjou-Pekam JN, Bowo-Ngandji A, Mahamat M, Nkie Esemu S, Ndip L, Njouom R. Global epidemiology of hepatitis C virus in dialysis patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0284169. [PMID: 38330063 PMCID: PMC10852299 DOI: 10.1371/journal.pone.0284169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/25/2023] [Indexed: 02/10/2024] Open
Abstract
Dialysis is a replacement therapy for patients with End-Stage Renal Disease (ESRD). Patients on dialysis are at high risk of acquiring hepatitis C virus (HCV), which has become a leading cause of morbidity and mortality in this population. There is a wide range of prevalence of HCV in dialysis populations around the world. It is still unknown how prevalent HCV infection is among worldwide dialysis patients (including those undergoing hemodialysis and peritoneal dialysis). A review was conducted to estimate the global epidemiology of hepatitis C in dialysis patients. We searched PubMed, Excerpta Medica Database (Embase), Global Index Medicus and Web of Science until October 2022. A manual search of references from relevant articles was also conducted. Heterogeneity was evaluated by the χ2 test on Cochrane's Q statistic, and the sources of heterogeneity were investigated using subgroup analysis. In order to assess publication bias, funnel plots and Egger tests were conducted, and pooled HCV prevalence estimates were generated using a DerSimonian and Laird meta-analysis model. The study is registered with PROSPERO under CRD42022237789. We included 634 papers involving 392160 participants. The overall HCV case fatality rate was 38.7% (95% CI = 28.9-49). The global prevalence of HCV infection in dialysis population group were 24.3% [95% CI = 22.6-25.9]. As indicated by UNSD region, country, dialysis type, and HCV diagnostic targeted; Eastern Europe had the highest prevalence of 48.6% [95% CI = 35.2-62], Indonesia had 63.6% [95% CI = 42.9-82], hemodialysis patients had 25.5% [95% CI = 23.8-27.3], and anti-HCV were detected in 24.5% [95% CI = 22.8-26.2]. Dialysis patients, particularly those on hemodialysis, have a high prevalence and case fatality rate of HCV infection. Hemodialysis units need to implement strict infection control measures.
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Affiliation(s)
- Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | | | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Maimouna Mahamat
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- Hemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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5
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Abbasi F, Almukhtar M, Fazlollahpour-Naghibi A, Alizadeh F, Behzad Moghadam K, Jafari Tadi M, Ghadimi S, Bagheri K, Babaei H, Bijani MH, Rouholamin S, Razavi M, Rezaeinejad M, Chemaitelly H, Sepidarkish M, Farid-Mojtahedi M, Rostami A. Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis. EClinicalMedicine 2023; 66:102327. [PMID: 38045801 PMCID: PMC10692665 DOI: 10.1016/j.eclinm.2023.102327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Background Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. Methods In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries' income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the "leave-one-out" method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. Findings We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72-1.89%) and 3.29% (3.01-3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39-8.29%) and lowest in the Western Pacific region (0.75%, 0.38-1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32-66.39) and HIV infection (4.34%, 95% CI: 2.21-7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02-1.15%), as confirmed by multivariable meta-regression (p < 0.001). A significant decreasing trend was observed with increasing human development index levels. Other important risk factors for HCV seropositivity included older age, lower educational levels, poly sexual activity, history of blood transfusion, hospitalization, surgery, abortion and sexual transmitted diseases, having scarification/tattoo or piercing, and testing hepatitis B positive. Interpretation This meta-analysis showed relatively high burden of exposure to HCV infection (2.2-5.3 million) in pregnant women globally. However, due to substantial heterogeneity between studies, our estimates might be different than the true seroprevalence. Our findings highlighted the need to expand HCV screening for women of reproductive age or during pregnancy, particularly in countries with high prevalence; as well as for more studies that assess safety of existing therapeutic drugs during pregnancy or potentially support development of drugs for pregnant women. Funding There was no funding source for this study.
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Affiliation(s)
- Farzaneh Abbasi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Andarz Fazlollahpour-Naghibi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Alizadeh
- Department of Pharmaceutical Sciences, University of Illinois, Chicago, USA
| | | | - Mehrdad Jafari Tadi
- Department of Cell and Molecular Medicine, Rush University Medical Centre, Chicago, IL, 60607, USA
| | - Saleh Ghadimi
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kimia Bagheri
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hedye Babaei
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Hossein Bijani
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Safoura Rouholamin
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Razavi
- Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahroo Rezaeinejad
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Farid-Mojtahedi
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Al Shukri I, Al Wahaibi A, Al Kindi H, Al-Maimani Y, Al Maani A, Alqayoudhi A, Methew MC, Pradeesh J, Al Abrawi R, Debs A, Mansoor N, AlRahbi A, Al Balushi W, Alharrasi M, Al Mamari B, Soliman MF, Alsenaidi A, Al Alawi M, Al Ismaili O, Al-Abri S, Al-Jardani A. The Seroprevalence of Hepatitis C Virus (HCV) in Hemodialysis Patients in Oman: A National Cross-Sectional Study. J Epidemiol Glob Health 2023; 13:774-781. [PMID: 37698781 PMCID: PMC10686920 DOI: 10.1007/s44197-023-00149-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND HCV infection in hemodialysis units is a significant cause of morbidity and mortality. The risk of HCV infection among dialysis patients is higher compared to the general population due to high potential blood exposures in hemodialysis settings. This study aims to assess the national HCV seroprevalence in selected dialysis units and to determine the risk factors for acquiring HCV infection. METHODS This cross-sectional study was conducted from 1 January to 31 March 2021. A total of 734 patients from 11 hemodialysis centers in Oman were included. Samples were tested simultaneously for HCV antibodies and HCV RNA. HCV genotyping was determined in all viremic patients. Demographic and hemodialysis center related data were gathered and their association with the positive HCV serology were explored using univariate and multivariate logistic regression analysis. RESULTS Out of 800 patients selected from 11 dialysis units for the study, 734 patients (91.8%) were included. The overall seroprevalence of HCV infection among hemodialysis patients was 5.6%. (41/734). HCV RNA was detected in 31.7% (13/41) of seropositive hemodialysis patients. The most common genotype was subtype 1a, followed by subtype 3. Variables associated with high HCV prevalence were family history of HCV and duration of dialysis. CONCLUSION The prevalence of infection within hemodialysis patients in Oman has significantly decreased but remained higher than the general population. Continuous monitoring and follow-up, including periodic serosurvey and linkage to care and treatment are recommended. Additionally, practice audits are recommended for identifying gaps and ensuring sustainability of best practices and further improvement.
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Affiliation(s)
- Intisar Al Shukri
- Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman
| | - Adil Al Wahaibi
- Department of Surveillance, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Hanan Al Kindi
- Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman
| | | | - Amal Al Maani
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Abdullah Alqayoudhi
- Department of Infection Prevention and Control, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Mersum C Methew
- Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman
| | - Jini Pradeesh
- Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman
| | | | - Abdo Debs
- Quriyat Hospital, Ministry of Health, Muscat, Oman
| | | | - Ahmed AlRahbi
- Ibra Dialysis Unit, Ministry of Health, Muscat, Oman
| | | | | | | | | | | | | | - Omaima Al Ismaili
- Department of Infection Prevention and Control, Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Seif Al-Abri
- Royal Hospital, Ministry of Health, Muscat, Oman
| | - Amina Al-Jardani
- Directorate General for Disease Surveillance and Control, Central Public Health Laboratories, Ministry of Health, Muscat, Oman.
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Marc L, Mihaescu A, Lupusoru R, Schiller O, Bob F, Chisavu L, Bende F, Sirli R, Schiller A. Hepatitis C and hepatitis B virus infection in hemodialysis patients after nationwide direct antiviral agents therapy-experience of 10 Romanian HD centers. Int Urol Nephrol 2023; 55:2951-2958. [PMID: 37024632 PMCID: PMC10560143 DOI: 10.1007/s11255-023-03587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/01/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE End-stage kidney disease patients (ESKD) receiving hemodialysis (HD) are at a greater risk of hepatitis virus (HV) infections due to the invasive nature of the procedures, frequent hospital stays and surgeries, as well as the immune deficiency status of ESKD. THE AIM This study was to reassess the hepatitis virus infections prevalence in the HD population in Romania after 5 years of oral DAAs therapy and assess the impact on HD patients' outcomes in two cohorts (2015 and 2019). METHODS We compared ESKD patients treated with HD in 10 HD centers from the historical regions of Romania in 2015 (n = 1401, Mean age 59.7 ± 12.92 years) with patients treated in the same centers in 2019 (n = 1698, mean age 61 ± 12.93 years). All patients went through HD therapy for more than 90 days. RESULTS The patients from the 2019 cohort were significantly older (p = 0.005), had a longer duration of HD therapy (p < 0.0001), and had more vascular calcifications (p = 0.015); the crude one-year mortality rate did not differ from the 2015 cohort (9.9 vs. 10.7%, p = 0.46). The prevalence of HBV infection did not differ between the cohorts (4.7% vs. 4.8, p = 0.604) but the prevalence of HCV significantly decreased from 2015 to 2019 (16.9 vs. 10.5%, p < 0.0001). CONCLUSION After 15 years of a nationwide infection prevention program for HV infections and 5 years of DAAs treatment in Romania, the prevalence of HBV did not change but HCV infections decreased significantly, however, it still remained high.
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Affiliation(s)
- Luciana Marc
- Department of Internal Medicine II – Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Nephrology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
- “Avitum” Center of Hemodialysis, Timisoara, Romania
| | - Adelina Mihaescu
- Department of Internal Medicine II – Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Nephrology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
- “Avitum” Center of Hemodialysis, Timisoara, Romania
| | - Raluca Lupusoru
- Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Internal Medicine II – Division of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Gastroenterology and Hepatology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
| | | | - Flaviu Bob
- Department of Internal Medicine II – Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Nephrology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
- “Avitum” Center of Hemodialysis, Timisoara, Romania
| | - Lazar Chisavu
- Department of Internal Medicine II – Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Nephrology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
- “Avitum” Center of Hemodialysis, Timisoara, Romania
| | - Felix Bende
- Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Internal Medicine II – Division of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Gastroenterology and Hepatology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
| | - Roxana Sirli
- Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Internal Medicine II – Division of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Gastroenterology and Hepatology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
| | - Adalbert Schiller
- Department of Internal Medicine II – Division of Nephrology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Nephrology Clinic - County Emergency Hospital “Pius Brinzeu”, Timisoara, Romania
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8
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Andrade JF, Dalboni MA, Clemente OC, Silva BM, Domingues BF, Rodrigues AM, Canziani ME, Zarjou A, Cendoroglo M, Goes MA. A retrospective view of the relationship of soluble Fas with anemia and outcomes in chronic kidney disease. PLoS One 2023; 18:e0286854. [PMID: 37390095 PMCID: PMC10313056 DOI: 10.1371/journal.pone.0286854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/24/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Anemia is common in chronic kidney disease (CKD) and is associated with outcomes. In addition, serum soluble Fas (sFas) levels are related to anemia and erythropoietin (EPO) resistance. OBJECTIVES Firstly, to compare clinical data and serum levels of sFas, EPO, and pro-inflammatory markers between patients with non-dialytic CKD (NDD-CKD) and healthy subjects. Subsequently, to compare and evaluate the relationship of serum EPO, sFas levels with anemia, and outcomes in patients with NDD-CKD over a long follow-up period. METHODS We performed a retrospective study in 58 NDD-CKD patients compared with 20 healthy subjects on complete blood count, kidney function, serum EPO, sFas, and inflammatory markers (CRP, IL- 6, and IFN-γ) at baseline. We then compared the same baseline data between patients with NDD-CKD who evolved to anemia and those who did not have anemia over the follow-up. We also evaluated the frequency of outcomes in patients with CKD with higher sFas levels. Finally, we performed a multivariate analysis of factors associated with CKD anemia. RESULTS There were lower eGFR and Hb but higher serum inflammatory markers, sFas levels, sFas/eGFR, and EPO/Hb ratios in patients with NDD-CKD. Comparatively, on the other hand, NDD-CKD patients with anemia had lower eGFR but were older, had more diabetes, and had higher sFas/ eGFR, EPO/Hb ratios, and serum levels of IL-6 and sFas than NDD-CKD without anemia for an extended period. In addition, there was an association in a multivariate analysis of diabetes, age, and sFas levels with kidney anemia. Furthermore, there were higher frequencies of outcomes in increased serum sFas levels. CONCLUSION As an elective risk factor, serum sFas levels, in addition to age and diabetes, were independently associated with kidney anemia for an extended period. Thus, more studies are necessary to analyze the proper relationship of sFas with kidney anemia and its outcomes and therapy in CKD.
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Affiliation(s)
| | - Maria A. Dalboni
- Department of Research and Graduate, Universidade Nove de Julho/UNINOVE, São Paulo, Brazil
| | | | | | | | | | | | - Abolfazl Zarjou
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Miguel Cendoroglo
- Department of Superintendence and Board, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Miguel Angelo Goes
- Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil
- Medical School, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
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9
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Wallez T, Labriola L, Jadoul M. Hepatitis C virus (HCV) in dialysis units: where are we now? J Nephrol 2023; 36:1233-1234. [PMID: 36930434 DOI: 10.1007/s40620-023-01602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/12/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Thibault Wallez
- Department of Nephrology, Cliniques universitaires Saint-Luc, University of Louvain Medical School, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Laura Labriola
- Department of Nephrology, Cliniques universitaires Saint-Luc, University of Louvain Medical School, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Michel Jadoul
- Department of Nephrology, Cliniques universitaires Saint-Luc, University of Louvain Medical School, Avenue Hippocrate 10, 1200, Brussels, Belgium.
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Yasuoka Y, Izumi Y, Sands JM, Kawahara K, Nonoguchi H. Progress in the Detection of Erythropoietin in Blood, Urine, and Tissue. Molecules 2023; 28:molecules28114446. [PMID: 37298922 DOI: 10.3390/molecules28114446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Detection of erythropoietin (Epo) was difficult until a method was developed by the World Anti-Doping Agency (WADA). WADA recommended the Western blot technique using isoelectric focusing (IEF)-PAGE to show that natural Epo and injected erythropoiesis-stimulating agents (ESAs) appear in different pH areas. Next, they used sodium N-lauroylsarcosinate (SAR)-PAGE for better differentiation of pegylated proteins, such as epoetin β pegol. Although WADA has recommended the use of pre-purification of samples, we developed a simple Western blotting method without pre-purification of samples. Instead of pre-purification, we used deglycosylation of samples before SDS-PAGE. The double detection of glycosylated and deglycosylated Epo bands increases the reliability of the detection of Epo protein. All of the endogenous Epo and exogenous ESAs shift to 22 kDa, except for Peg-bound epoetin β pegol. All endogenous Epo and exogenous ESAs were detected as 22 kDa deglycosylated Epo by liquid chromatography/mass spectrum (LC/MS) analysis. The most important factor for the detection of Epo is the selection of the antibody against Epo. WADA recommended clone AE7A5, and we used sc-9620. Both antibodies are useful for the detection of Epo protein by Western blotting.
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Affiliation(s)
- Yukiko Yasuoka
- Department of Physiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0374, Japan
| | - Yuichiro Izumi
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Jeff M Sands
- Renal Division, Department of Medicine, Emory University School of Medicine, 1639 Pierce Drive, WMB Room 3313, Atlanta, GA 30322, USA
| | - Katsumasa Kawahara
- Department of Physiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0374, Japan
| | - Hiroshi Nonoguchi
- Division of Internal Medicine, Kitasato University Medical Center, 6-100 Arai, Kitamoto 364-8501, Japan
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