The prevalence of HCV RNA positivity in anti-HCV antibodies-negative hemodialysis patients in Thrace Region. Multicentral study

The aims of this study were to (i) evaluate the prevalence and the incidence of hepatitis C virus (HCV) infection in hemodialysis patients in two different centers in São Paulo (Brazil), (ii) determine the time required to detect HCV infection among these patients by serology or PCR, (iii) establish the importance of alanine aminotransferase determination as a marker of HCV infection, and (iv) identify the HCV genotypes in this population. Serum samples were collected monthly for 1 year from 281 patients admitted to hospital for hemodialysis. Out of 281 patients, 41 patients (14.6%) were HCV positive; six patients seroconverted during this study (incidence = 3.1/1000 person-month). In 1.8% (5/281) of cases, RNA was detected before the appearance of antibodies (up to 5 months), and in 1.1% (3/281) of cases, RNA was the unique marker of HCV infection. The genotypes found were 1a, 1b, 3a, and 4a. The presence of genotype 4a is noteworthy, since it is a rare genotype in Brazil. These data pointed out the high prevalence and incidence of HCV infection at hemodialysis centers in Brazil and showed that routine PCR is fundamental for improving the detection of HCV carriers among patients undergoing hemodialysis.Key words: HCV genotypes, hemodialysis, hepatitis C, PCR, prevalence, incidence.

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Characterization of Occult Hepatitis C Virus (Hcv) Infection among Hemodialysis Patient

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1138 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Siti Nurul Fazlin Abdul Rahman ◽

Hairul Aini binti Hamzah ◽

Mohammed Imad Mustafa ◽

Mohamed Hadzri Hasmoni

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Viral Rna ◽

Cell Counting ◽

Hcv Rna ◽

Viral Rnas ◽

Occult Hepatitis ◽

Occult Hepatitis C

Introduction: The existence of new entity called occult hepatitis C virus (HCV) has become a raising and escalating concern among healthcare professionals worldwide. It is defined by the presence of viral RNA in liver and/or peripheral blood mononuclear cells (PBMCs) within non HCV-infected patients. Previous study had shown the occult HCV is infectious and capable of transmitting the virus to another host. Till today, HCV infection remains common among hemodialysis patients despite having the best preventive plans. Because of this, there is a significant concern about the source of viral transmission. The aim of the study was to identify and characterize occult HCV infection in PBMC sample of hemodialysis patients. This was an observational and cross sectional study. Materials and method: PBMCs were isolated from the whole blood using Ficoll-gradient centrifugation technique. The PBMCs were then subjected for cell counting and stored in -70O C until further used. HCV RNA were extracted from these cells and viral RNA were subjected for molecular assays, immune cells analysis and cells culture. Results: PBMCs were isolated from eleven (11) study patients and five (5) anti-HCV positive (control) patients. By using automated flow cytometry, PBMCs of each sample were counted and the average number of cells obtained range from 2x104 to 5x106 cells/ ml. Viral RNAs were extracted and quantitatively measured by using NanoDrop Spectrophotometers. The viral RNAs concentration obtained were between 24.7 and 258.9 ng/ml. The RNAs would be subjected for purification (ethanol precipitation) and further assays. Conclusion: The final findings might contribute to the clinical management of dialysis patients.

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SP315ARCHITECT HEPATITIS C VIRUS (HCV) CORE ANTIGEN TEST: A HCV RNA SCREENING ALTERNATIVE IN END-STAGE RENAL DISEASE (ESRD) AND HEMODIALYSIS PATIENTS?

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy104.sp315 ◽

2018 ◽

Vol 33 (suppl_1) ◽

pp. i450-i450

Author(s):

Rita Valério Alves ◽

Rita Abrantes ◽

Hernâni Gonçalves ◽

Maria Leonor Gonçalves ◽

Karina Lopes ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Renal Disease ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Core Antigen ◽

Hcv Rna ◽

Antigen Test ◽

Stage Renal Disease ◽

End Stage

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Patient-Care Practices Associated with an Increased Prevalence of Hepatitis C Virus Infection among Chronic Hemodialysis Patients

Infection Control and Hospital Epidemiology ◽

10.1086/659407 ◽

2011 ◽

Vol 32 (5) ◽

pp. 415-424 ◽

Cited By ~ 29

Author(s):

Gayle Shimokura ◽

Feng Chai ◽

David J. Weber ◽

Gregory P. Samsa ◽

Guo-liang Xia ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Patient Care ◽

The United States ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hcv Infection ◽

Hcv Rna ◽

Infection Prevalence ◽

Care Practices

Objective.To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Design.Survey.Setting.Chronic hemodialysis facilities in the United States.Participants.Equal-probability 2-stage cluster sampling was used to select 87 facilities from all Medicare-approved providers treating 30–150 patients; 53 facilities and 2,933 of 3,680 eligible patients agreed to participate.Methods.Patients were tested for HCV antibody and HCV RNA. Data on patient-care practices were collected using direct observation.Results.The overall prevalence of HCV infection was 9.9% (95% confidence interval [CI], 8.2%–11.6%); only 2 of 294 HCV-positive patients were detected solely by HCV RNA testing. After adjusting for non-dialysis-related HCV risk factors, patient-care practices independently associated with a higher prevalence of HCV infection included reusing priming receptacles without disinfection (odds ratio [OR], 2.3 [95% CI, 1.4–3.9]), handling blood specimens adjacent to medications and clean supplies (OR, 2.2 [95% CI, 1.3–3.6]), and using mobile carts to deliver injectable medications (OR, 1.7 [95% CI, 1.0–2.8]). Independently related facility covariates were at least 10% patient HCV infection prevalence (OR, 3.0 [95% CI, 1.8–5.2]), patient-to-staff ratio of at least 7: 1 (OR, 2.4 [95% CI, 1.4–4.1]), and treatment duration of at least 2 years (OR, 2.4 [95% CI, 1.3–4.4]).Conclusions.This study provides the first epidemiologic evidence of associations between specific patient-care practices and higher HCV infection prevalence among hemodialysis patients. Staff should review practices to ensure that hemodialysis-specific infection control practices are being implemented, especially handling clean and contaminated items in separate areas, reusing items only if disinfected, and prohibiting mobile medication and clean supply carts within treatment areas.

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Prevalence of Hepatitis C Infection and its Genotypes in Suspected Hemodialysis Patients, Southwest of Iran

Jundishapur Journal of Microbiology ◽

10.5812/jjm.118591 ◽

2021 ◽

Vol 14 (11) ◽

Author(s):

Marzieh Jamalidoust ◽

Maryam Eskandari ◽

Mazyar Ziyaeyan

Keyword(s):

Viral Load ◽

Hepatitis C ◽

Management Practices ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Research Center ◽

Enzyme Linked Immunosorbent Assay ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Genotype 3

Background: Hemodialysis patients are more prone to Hepatitis C Virus (HCV) infection due to the need for long-term hemodialysis and blood transfusions. Objectives: The present study aimed to determine the HCV infection burden, viral load, and genotype pattern in hemodialysis patients referred to a research center from 2011 to 2018. Methods: Among 131 hemodialysis patients with suspected HCV infection, referred to Prof. Alborzi Clinical Microbiology Research Center, Shiraz, Iran, from 2011 to 2018, the HCV rate was assessed with the enzyme-linked immunosorbent assay and the HCV RNA load and genotypes by one-step TaqMan real-time PCR. Results: The prevalence of HCV-Ab positivity was 29% among hemodialysis patients, of whom 21 (57%) were HCV RNA-positive. In the rest of the hemodialysis patients who were HCV-Ab-negative, the HCV RNA was detected in five (12%) patients. Genotype 3 (Gt-3) was the most prevalent one detected in 50% of the patients whose genotypes were determined. Also, the HCV viral load in HCV-seropositive patients was generally higher than that in HCV-seronegative ones. Conclusions: This study showed that high HCV infection and different genotype patterns among hemodialysis patients compared to the general population are the main predictors of HCV infection, which indicates healthcare facility transmission because of inappropriate infection management practices.

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Prevalence of Occult Hepatitis C Virus Infection among Egyptian Haemodialysis Patients

QJM ◽

10.1093/qjmed/hcab100.036 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Noha Abd EL-Razek El-Nakeeb ◽

Moataz Mohamed El-Sayed ◽

Tari Magdy Aziz George ◽

Amira Mohamed Helmy Okasha El-Araishy

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Peripheral Blood Mononuclear Cells ◽

Mononuclear Cells ◽

Hemodialysis Patients ◽

Hcv Rna ◽

Peripheral Blood Mononuclear ◽

Occult Hepatitis ◽

Blood Mononuclear Cells ◽

Occult Hepatitis C

Abstract Background Hepatitis C Virus (HCV) infection is a global health problem. OCI is characterized by presence of HCV-RNA in the liver tissue only and/or Peripheral Blood Mononuclear Cells (PBMCs) with undetectable HCV-RNA or antibodies in the serum. Support for presence of this entity comes from the observation that HCV, even though a hepatotropic virus, can replicate as well at extrahepatic sites, including peripheral blood mononuclear cells. Objectives The current study evaluated the hidden infection of hepatitis C virus among patients on maintenance hemodialysis with negative ELISA and PCR by using PCR in mononuclear cells as a marker in these patients. Our study was done in Sharkia Governorate. Patients and Methods In our study, the 60 included subjects had an average age of 48.27 years with range from 19 to 77 years and included 33 males (55%) and 27 females (45%). The subjects had average dialysis duration of 6.51 ± 4.10years with range from 7 months to 19 years. Results Our study showed no statistically significant differences between occult HCV cases and negative cases in frequency of blood transfusion. There were no statistically significant differences between occult HCV cases and negative cases in splenomegaly, hepatomegaly or coarse liver but there was a statistically significant increase in frequency of severe ascites, moderate LL edema and jaundice among occult HCV cases compared to negative cases. There were no statistically significant differences between occult HCV cases and negative cases in urea, creatinine, ALT, AST or albumin. In our study total bilirubin>1.7 and direct bilirubin >0.4 were significant predictors for the presence of occult HCV in hemodialysis patients. Our study showed that there were no statistically significant correlation between viral load in PBMCs and laboratory findings among occult HCV cases. Conclusion Hemodialysis patients are liable for occult HCV infections with a considerable impact on their health. Total and direct bilirubin are predictors of presence of occult hepatitis C infection at cut-off values of 1.7 mg/dl and 0.4 mg/dl respectively.

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Evaluation of the amplicor? HCV RNA qualitative assay in peripheral blood mononuclear cells of hemodialysis patients . University Hospital of Amiens, *Roche Diagnostic Systems, France

Hepatology ◽

10.1016/0270-9139(95)95772-3 ◽

1995 ◽

Vol 22 (4) ◽

pp. A513

Keyword(s):

Peripheral Blood Mononuclear Cells ◽

Peripheral Blood ◽

Mononuclear Cells ◽

Hemodialysis Patients ◽

University Hospital ◽

Hcv Rna ◽

Diagnostic Systems ◽

Peripheral Blood Mononuclear ◽

Blood Mononuclear Cells ◽

Qualitative Assay

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Hepatitis C virus infection in hemodialysis patients: comparison of two new hepatitis C antibody assays with a second-generation assay.

Journal of the American Society of Nephrology ◽

10.1681/asn.v651439 ◽

1995 ◽

Vol 6 (5) ◽

pp. 1439-1444

Author(s):

K al Meshari ◽

O Alfurayh ◽

M Al Ahdal ◽

W Qunibi ◽

G Kessie ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Predictive Value ◽

Second Generation ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Hcv Rna ◽

Immunoblot Assay ◽

Antibody Assays ◽

Recombinant Immunoblot Assay

The performance of two new hepatitis C virus antibody (anti-HCV) assays (a third-generation immunoglobulin (Ig)G recombinant immunoblot assay (RIBA 3.0) and hepatitis C virus core IgM (HCV IgM) in the prediction of hepatitis C viremia in hemodialysis patients was compared with that of a second-generation IgG recombinant immunoblot assay (RIBA 2.0). Forty-three patients on maintenance hemodialysis were studied. Aliquots of sera were tested prospectively for anti-HCV by RIBA 2.0, RIBA 3.0, and HCV IgM and for HCV RNA by polymerase chain reaction. Thirty-eight patients were HCV RNA positive. Among those, 7 (18%) were HCV IgM positive, 22 (58%) were RIBA 2.0 positive, and 29 (76%) were RIBA 3.0 positive. All but one viremic patients detected by HCV IgM were also detected by RIBA 2.0 and RIBA 3.0. All viremic patients detected by RIBA 2.0 were also detected by RIBA 3.0. RIBA 3.0 was more sensitive than RIBA 2.0 and HCV IgM in the detection of viremic patients (P = 0.0156 and < 0.0001, respectively). The positive predictive value for HCV IgM was 100% as compared with 96 and 97% for RIBA 2.0 and RIBA 3.0, respectively. The negative predictive value for RIBA 3.0 was 36% as compared with 24 and 14% for RIBA 2.0 and HCV IgM, respectively. At 6-months follow-up of the eight viremic patients without a detectable IgM or IgG anti-HCV response, all patients remained RIBA 2.0 nonreactive, one became RIBA 3.0 indeterminate, and one became HCV IgM positive. These data suggest that HCV IgM has poor sensitivity in the detection of hepatitis C viremia and RIBA 3.0 improves the sensitivity of IgG anti-HCV assays in the early detection of hepatitis C viremia in hemodialysis patients.

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Boceprevir-Based Triple Antiviral Therapy for Chronic Hepatitis C Virus Infection in Kidney-Transplant Candidates

Journal of Transplantation ◽

10.1155/2015/159795 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Mireille Mehawej ◽

Lionel Rostaing ◽

Laurent Alric ◽

Arnaud Del Bello ◽

Jacques Izopet ◽

...

Keyword(s):

Antiviral Therapy ◽

Antiviral Agents ◽

Pegylated Interferon ◽

Hemodialysis Patients ◽

Hcv Rna ◽

Partial Responder ◽

Direct Acting Antiviral ◽

Chronic Hcv ◽

Few Data ◽

Direct Acting

Background. There are few data on the combination of (pegylated-) interferon- (Peg-IFN-)α, ribavirin, and first-generation direct-acting antiviral agents (DAAs). Our aim was to describe the efficacy and safety of Peg-IFN-α, ribavirin, and boceprevir in hemodialysis patients.Patients. Six hemodialysis patients, chronically infected by genotype-1 HCV, were given Peg-IFN-α(135 µg/week), ribavirin (200 mg/d), and boceprevir (2400 mg/d) for 48 weeks.Results. At initiation of antiviral therapy, median viral concentration was 5.68 (3.78–6.55) log IU/mL. HCV RNA was undetectable in four of the six patients at week 4 and in all patients at week 24. A breakthrough was observed in two patients between weeks 24 and 48, and a third patient stopped antiviral therapy between weeks 24 and 48 because of severe peripheral neuropathy. At week 48, HCV RNA was undetectable in three patients. Of these, two patients relapsed within a month after antiviral therapy was stopped. Hence, only one patient had a sustained virological response; he was a previous partial responder. Overall, anemia was the main side effect.Conclusion. A triple antiviral therapy based on Peg-IFN-α, ribavirin, and boceprevir is not optimal at treating hemodialysis patients with chronic HCV infection. Studies using new-generation drugs are required in this setting.

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