Commentary on: Treatment of HCV infection in chronic kidney disease
Commentary on: Treatment of HCV infection in chronic kidney disease
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The prevalence of Hepatitis C virus (HCV) infection in hemodialysis (HD) patients varies markedly from country to country<span class="elsevierStyleSup">2</span>. The main risk factors for HCV infection in this special group are blood transfusions, length of dialysis time and nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure<span class="elsevierStyleSup">3-6</span>. Control of HCV infection in hemodialysis setting is possible<span class="elsevierStyleSup">7,8</span>. Integration of surveillance system for early detection, treating all of treatable patients with alpha interferon, putting HCV-infected patients on the top list for renal transplantation, training the staffs in hemodialysis patients and using more the erythropoietin instead blood transfusion. The prevalence of HCV infection may be underestimated according to an antibody assay alone<span class="elsevierStyleSup">9</span>. First of all, I would like to present a dilemma regarding liver biopsy in hemodialysis patients with HCV infection. Liver biopsy in hemodialysis patients is with higher risk of bleeding and other complication and it should do by Trans-jugular or in very specialized center. In treatment of HCV infection in hemodialysis patients, we are not sure regarding superiority of pegylated interferon (IFN) on conventional IFN<span class="elsevierStyleSup">10,11</span> and in a meta-analysis The pooled sustained virologic response (SVR) for standard and pegylated IFN monotherapy in random effects model was 39.1% (95% confidence interval [CI], 32.1 to 46.1) and 39.3% (95% CI, 26.5 to 52.1), respectively<span class="elsevierStyleSup">10</span>. The difference was not significant, but it is important to treat the patients before 40 years old and as soon as possible<span class="elsevierStyleSup">10,12</span>. Individuals on dialysis with chronic hepatitis C who were treated with interferon or pegylated interferon plus ribavirin can have higher SVR rate than dialysis patients treated with interferon or pegylated interferon alone. Administration of ribavirin with close monitoring of CBC and serum ribavirin concentration can be safe<span class="elsevierStyleSup">13</span>.</p>" "pdfFichero" => "P1-E524-S3252-A10983.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "1.\u{A0}Aoufi Rabih S, García Agudo R. Treatment of HCV infection in chronic kidney disease. Nefrologia 2011;31(3):260-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21407274" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "2.\u{A0}Alavian SM, Tabatabaei SH, Mahboobi N. Epidemiology and risk factors of HCV infection among hemodialysis patients in countries of the Eastern Mediterranean Regional Office of WHO (EMRO): a quantitative review of literature. J Public Health (Oxf) 2011;19:191-203." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "3.\u{A0}Alavian SM. A shield against a monster: Hepatitis C in hemodialysis patients. World J Gastroenterol 2009;15(6):641-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19222088" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "4.\u{A0}Alavian SM, Kabir A, Ahmadi AB, Lankarani KB, Shahbabaie MA, Ahmadzad-Asl M. Hepatitis C infection in hemodialysis patients in Iran: A systematic review. Hemodial Int 2010;14(3):253-62. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20491973" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "5.\u{A0}Mansour-Ghanaei F, Sadeghi A, Mashhour MY, Joukar F, Besharati S, Roshan ZA, et al. Prevalence of hepatitis B and C infection in hemodialysis patients of Rasht (Center of Guilan Province, Northern Part of Iran). Hepat Mon 2009;9(1):45-9." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "6.\u{A0}Alavian SM, Einollahi B, Hajarizadeh B, Bakhtiari S, Nafar M, Ahrabi S. Prevalence of hepatitis C virus infection and related risk factors among Iranian haemodialysis patients. Nephrology (Carlton) 2003;8(5):256-60." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "7.\u{A0}Alavian SM. Hepatitis C, chronic renal failure, control is possible! Hepat Mon 2006;6(2):51-2." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "8.\u{A0}Nemati E, Taheri S, Einollahi B. Hepatitis C among hemodialysis patients: impact of strict adherence to universal precautions. Hepat Mon 2007;7(4):245-6." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "9.\u{A0}Einollahi B, Alavian SM. Hepatitis C virus infection and kidney transplantation: a review for clinicians. Iran J Kidney Dis 2010;4(1):1-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20081297" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "10.\u{A0}Alavian SM, Tabatabaei SV. Meta-analysis of factors associated with sustained viral response in patients on hemodialysis treated with standard or pegylated interferon for hepatitis C infection. Iran J Kidney Dis 2010;4(3):181-94. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20622305" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "11.\u{A0}Hosseini Moghaddam SM, Alavian SM, Rahnavardi M. Therapeutic aspects of hepatitis C in hemodialysis patients. Am J Nephrol 2009;29(2):123-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18719345" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "12.\u{A0}Alavian SM, Hosseini-Moghaddam SM, Rahnavardi M. Hepatitis C among hemodialysis patients: a review on epidemiologic, diagnostic, and therapeutic features. Hepat Mon 2007;7(3):153-62." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "13.\u{A0}Alavian SM, Tabatabaee V, Lankarani KB. Ribavirin combination therapy of chronic hepatitis C patients with end stage renal disease: review of evidences on efficacy and safety. Int J Nephrol Urol 2011;3(1):1-7." 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