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Chariyavilaskul P, Prompila N, Wittayalertpanya S, Lekhyananda S, Prasithsirikul W, Trakarnvanich T, Jeenapongsa S, Susantitaphong P, Kerr S, Avihingsanon A, Tangkijvanich P, Praditpornsilpa K. Pharmacokinetics of Sofosbuvir/Velpatasvir and efficacy of an alternate-day treatment in hemodialysis patients with chronic hepatitis C infection. Clin Transl Sci 2024; 17:e13884. [PMID: 39004798 PMCID: PMC11246974 DOI: 10.1111/cts.13884] [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: 02/19/2024] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
Sofosbuvir/Velpatasvir (SOF/VEL) is a combination drug used for chronic hepatitis C (HCV) infection. However, limited information exists regarding the pharmacokinetics of SOF/VEL and its metabolites in hemodialysis patients. We conducted a prospective investigation of the pharmacokinetic parameters of SOF/VEL after a single dose of SOF/VEL (400/100 mg) on days with and without dialysis in 12 Thai hemodialysis patients with chronic HCV infection, who had been undergoing hemodialysis for a duration of 0.5-20 years. Blood samples were collected before dose (0) and 0.5, 1.0, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, and 12.0 h after dose. Dialysate samples were also collected before dose (0) and 1.0, 2.0, 3.0, and 4.0 h after dose. Plasma and dialysate samples were quantified for SOF and its metabolite, GS-331007, and VEL concentrations using a fully validated LCMS technique. In addition, a preliminary efficacy study was conducted using the proposed SOF/VEL dose reduction regimen in all patients. No differences in SOF/VEL PK parameters between on- and off-dialysis studies. On the contrary, GS-331007 exhibited a 30% reduction in the area under the plasma concentration-time curve from time 0 to 24 h (AUC0-24h) on dialysis days compared with non-dialysis days (AUC0-24h ratio 0.68 vs. 1.04, respectively). The dialysis clearance of SOF and GS-331007 was 9.35 (8.72-15.11) and 8.89 (8.52-14.07) mL/min, respectively. Subsequently, an alternate-day regimen of SOF/VEL (400/100 mg) was administered for 12 weeks, resulting in an undetectable plasma HCV viral load without side effects. Further clinical studies are warranted to validate the efficacy and safety of our proposed dose reduction regimen.
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Affiliation(s)
- Pajaree Chariyavilaskul
- Center of Excellence in Clinical Pharmacokinetics and Pharmacogenomics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nantaporn Prompila
- Center of Excellence in Clinical Pharmacokinetics and Pharmacogenomics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chula Pharmacokinetic Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supeecha Wittayalertpanya
- Center of Excellence in Clinical Pharmacokinetics and Pharmacogenomics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chula Pharmacokinetic Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Wisit Prasithsirikul
- Department of Disease Control, Bamrasnaradura Infectious Institute, Ministry of Public Health, Thailand
| | | | | | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Stephen Kerr
- Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anchalee Avihingsanon
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Pisit Tangkijvanich
- Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kearkiat Praditpornsilpa
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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The Impact of Antiviral Treatment of Hepatitis B Virus after Kidney Transplant and the Latest Insights. Pathogens 2023; 12:pathogens12020340. [PMID: 36839612 PMCID: PMC9962423 DOI: 10.3390/pathogens12020340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The current frequency of hepatitis B virus infection in patients with advanced chronic kidney disease (CKD) (including patients on maintenance dialysis and kidney transplant recipients) is low but not negligible worldwide. HBV has a deleterious effect on survival after a kidney transplant; antiviral treatments improved the short-term outcomes of kidney transplant recipients, but their long-term impact remains uncertain. AIM The aim of this review is to assess the role of antiviral therapy for HBV in improving survival after a kidney transplant. The recent publication of large surveys has prompted us to update the available evidence on the impact of HBV on patient and graft survival after a kidney transplant. METHODS We have conducted an extensive review of the medical literature, and various research engines have been used. RESULTS We retrieved several studies (n = 11; n = 121,436 unique patients) and found an association between positive serologic HBsAg status and diminished patient and graft survival after a kidney transplant; the adjusted relative risk (aRR) of all-cause mortality and graft loss was 2.85 (95% CI, 2.36; 3.33, p < 0.0001) and 1.26 (95% CI, 1.02; 1.51, p < 0.0001), respectively. To our knowledge, at least six studies reported improved patient and graft survival after the adoption of antiviral therapies for HBV (this result was reported with both survival curves and multivariable regression). According to novel clinical guidelines, entecavir has been suggested as a 'first line' antiviral agent for the treatment of HBV after a kidney transplant. CONCLUSIONS The recent availability of safe and effective antiviral drugs for the treatment of HBV has meant that the survival curves of HBsAg-positive patients on antiviral therapy and HBsAg-negative patients after a kidney transplant can be comparable. Antiviral therapy should be systematically proposed to HBV-positive kidney transplant recipients and candidates to avoid the deleterious hepatic and extra-hepatic effects of chronic HBV replication.
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Immune Response after SARS-CoV-2 Vaccination in Kidney Transplant Patients. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121327. [PMID: 34946272 PMCID: PMC8703670 DOI: 10.3390/medicina57121327] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 01/14/2023]
Abstract
Background and Objectives: The prospective study was conducted to evaluate humoral and cellular immune responses after two doses of BNT162b2 (Pfizer-BioNTech) vaccine and possible relation with other factors (medication, etc.) in kidney transplant patients. Materials and Methods: Out of 167 vaccinated patients, 136 agreed to a follow-up visit three to six weeks after vaccination. Results: Only 39 patients (29%) developed antibody response against SARS-CoV-2 (≥35.2 binding antibody units (BAU)/mL) after full vaccination. Multivariate binary logistic regression analysis showed that predictive factors for good antibody response to the COVID-19 vaccine were better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression. For seropositive kidney transplant patients there was a significant negative correlation between anti-SARS-CoV-2 antibody titer and CD4/CD8 ratio (Spearman's correlation coefficient -0.4, p = 0.02), percentage of CD19+ cells (r = -0.37, p = 0.02), and a positive correlation with percentage of CD8+ cells (r = 0.4, p = 0.01). There was an increase of total leucocyte count after vaccination in the total studied population, and in the group of responders. Conclusions: Only one third of kidney transplant patients develop sufficient antibody responses after full COVID-19 vaccination with Pfizer-BioNTech. Better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression increases the adequacy of response. The antibody titers correlated positively with relative number of CD8+ cells and negatively with CD4/CD8 ratio in responders.
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Leroi C, Adam P, Khamduang W, Kawilapat S, Ngo-Giang-Huong N, Ongwandee S, Jiamsiri S, Jourdain G. Prevalence of chronic hepatitis B virus infection in Thailand: a systematic review and meta-analysis. Int J Infect Dis 2016; 51:36-43. [DOI: 10.1016/j.ijid.2016.08.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/19/2016] [Accepted: 08/23/2016] [Indexed: 12/11/2022] Open
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Kwon E, Cho JH, Jang HM, Kim YS, Kang SW, Yang CW, Kim NH, Kim HJ, Park JM, Lee JE, Jung HY, Choi JY, Park SH, Kim CD, Kim YL. Differential Effect of Viral Hepatitis Infection on Mortality among Korean Maintenance Dialysis Patients: A Prospective Multicenter Cohort Study. PLoS One 2015; 10:e0135476. [PMID: 26263373 PMCID: PMC4532453 DOI: 10.1371/journal.pone.0135476] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/22/2015] [Indexed: 02/06/2023] Open
Abstract
The role of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in terms of survival among dialysis patients remains incompletely understood. In the present multicenter prospective cohort study, we investigated the prevalences of HBV and HCV infection among 3,321 patients receiving maintenance dialysis in Korea, and assessed the impacts of these infections on survival. All included patients underwent hepatitis B antigen (HBsAg) and HCV antibody (Ab) testing, which revealed that 236 patients (7.1%) were HBsAg-positive, and 123 patients (3.7%) were HCV Ab-positive. HBsAg-positive and HCV Ab-positive patients were matched to hepatitis virus-negative patients using a propensity score at a ratio of 1:2. The prevalences of HBV and HCV infection did not significantly differ according to dialysis modality. Linear-by-linear association analysis revealed that hepatitis B prevalence significantly increased with increasing dialysis vintage (p = 0.001), and hepatitis C prevalence tended to be higher with increasing dialysis vintage (p = 0.074). We compared the survival of HBsAg-positive and HCV Ab-positive patients to that of hepatitis virus-negative patients. After propensity score matching, cumulative survival did not differ between HBsAg-positive and HBsAg-negative patients (p = 0.37), while HCV Ab-positive patients showed significantly lower survival than HCV Ab-negative patients (p = 0.03). The main conclusions of the present study are that HBV infection prevalence increased with longer dialysis vintage, and that both HBV and HCV infections were most prevalent among patients with the longest dialysis vintage. Additionally, HCV infection among maintenance dialysis patients is associated with an increased risk of mortality.
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Affiliation(s)
- Eugene Kwon
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Jang-Hee Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Hye Min Jang
- Department of Statistics, Kyungpook National University, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Chul Woo Yang
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Nam-Ho Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Hyun-Ji Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Jeung-Min Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Ji-Eun Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Hee-Yeon Jung
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Ji-Young Choi
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Sun-Hee Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease in Korea
- BK21Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Daegu, Korea
- * E-mail:
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Noor A, Bashir S, Earnshaw VA. Bullying, internalized hepatitis (Hepatitis C virus) stigma, and self-esteem: Does spirituality curtail the relationship in the workplace. J Health Psychol 2015; 21:1860-9. [PMID: 25603927 DOI: 10.1177/1359105314567211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to examine the impact of workplace bullying on self-esteem, including the mediating effect of internalized stigma and the moderating effect of spirituality, among hepatitis C virus patients. Data were collected from 228 employed hepatitis C virus patients who had been admitted to Gastroenterology and Hepatology wards in Pakistani hospitals. We found support for the hypothesis that workplace bullying is associated with low self-esteem via internalized stigma. In addition, spirituality moderated the association such that participants with greater spirituality were buffered from the impact of stigma on self-esteem.
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Affiliation(s)
- Ayesha Noor
- Capital University of Science and Technology, Islamabad, Pakistan
| | - Sajid Bashir
- Capital University of Science and Technology, Islamabad, Pakistan
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Grzegorzewska AE. Hepatitis B vaccination in chronic kidney disease: review of evidence in non-dialyzed patients. HEPATITIS MONTHLY 2012; 12:e7359. [PMID: 23326280 PMCID: PMC3546461 DOI: 10.5812/hepatmon.7359] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 08/29/2012] [Accepted: 09/02/2012] [Indexed: 02/06/2023]
Abstract
CONTEXT Hepatitis B vaccination of hemodialysis patients is performed all over the world. There are also recommendations from world health organizations to vaccinate patients with chronic kidney disease (CKD) prior dialysis commencement, but the implementation of a hepatitis B vaccination program is less common and not well organized. EVIDENCE ACQUISITION This review article summarizes data indicating why, when and how to vaccinate CKD patients before they start renal replacement therapy. Publication for this review was bringing into being from PubMed. RESULTS There is an agreement in the nephrological societies and among clinicians and scientists that CKD patients should be vaccinated in early stages of their disease, because a higher glomerular filtration rate is more likely to be associated with the responsiveness to vaccination. Schedules of vaccination and optimal vaccine doses are still being investigated. Differences in data with respect to these problems may result from comparisons of various vaccine doses and vaccination schedules without reference to one gold standard, variations in patients` clinical status and glomerular filtration rate, and also the small groups of the affected patients make statistical analysis non-conclusive. A titer of antibodies to surface antigen of hepatitis B virus (anti-HBs) > 10 IU/L or ≥ 10 IU/L is commonly considered as a marker of seroconversion to anti-HBs positivity after vaccination in both non-dialyzed and dialyzed patients. In advanced CKD, vaccine-induced serconversion rate is seldom observed in more than 90% of vaccinees. Various strategies have been utilized in order to increase vaccine-induced seroconversion rate in patients with advanced CKD. Changing the injection mode, the use of adjuvants and immunostimulants to improve the immunogenicity of existing recombinant hepatitis B vaccines, introduction of mammalian-cell derived pre-S/S HBV vaccines (third-generation vaccines) were tried in order to improve the immunization rate. CONCLUSIONS There are a substantial number of non-responders to the hepatitis B vaccine among CKD patients. Therefore, successful prevention of hepatitis B virus transmission and spread will only be attained when hepatitis B vaccination is applied together with full implementation of appropriate infection control procedures.
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Affiliation(s)
- Alicja E. Grzegorzewska
- Department of Nephrology, Transplantology and Internal Diseases, Poznań University of Medical Sciences, Poznań, Poland
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Dunford L, Carr MJ, Dean J, Waters A, Nguyen LT, Ta Thi TH, Thi LAB, Do HD, Thi TTD, Nguyen HT, Diem Do TT, Luu QP, Connell J, Coughlan S, Nguyen HT, Hall WW, Nguyen Thi LA. Hepatitis C virus in Vietnam: high prevalence of infection in dialysis and multi-transfused patients involving diverse and novel virus variants. PLoS One 2012; 7:e41266. [PMID: 22916104 PMCID: PMC3419252 DOI: 10.1371/journal.pone.0041266] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 06/19/2012] [Indexed: 12/22/2022] Open
Abstract
Hepatitis C virus (HCV) is a genetically diverse pathogen infecting approximately 2–3% of the world's population. Herein, we describe results of a large, multicentre serological and molecular epidemiological study cataloguing the prevalence and genetic diversity of HCV in five regions of Vietnam; Ha Noi, Hai Phong, Da Nang, Khanh Hoa and Can Tho. Individuals (n = 8654) with varying risk factors for infection were analysed for the presence of HCV Ab/Ag and, in a subset of positive specimens, for HCV RNA levels (n = 475) and genotype (n = 282). In lower risk individuals, including voluntary blood donors, military recruits and pregnant women, the prevalence of infection was 0.5% (n = 26/5250). Prevalence rates were significantly higher (p<0.001) in intravenous drug users (IDUs; 55.6%, n = 556/1000), dialysis patients (26.6%, n = 153/575) commercial sex workers (CSWs; 8.7%, n = 87/1000), and recipients of multiple blood transfusions (6.0%, n = 32/529). The prevalence of HCV in dialysis patients varied but remained high in all regions (11–43%) and was associated with the receipt of blood transfusions [OR: 2.08 (1.85–2.34), p = 0.001], time from first transfusion [OR: 1.07 (1.01–1.13), p = 0.023], duration of dialysis [OR: 1.31 (1.19–1.43), p<0.001] and male gender [OR: 1.60 (1.06–2.41), p = 0.026]. Phylogenetic analysis revealed high genetic diversity, particularly amongst dialysis and multi-transfused patients, identifying subtypes 1a (33%), 1b (27%), 2a (0.4%), 3a (0.7%), 3b (1.1%), 6a (18.8%), 6e (6.0%), 6h (4.6%), 6l (6.4%) and 2 clusters of novel genotype 6 variants (2.1%). HCV genotype 1 predominated in Vietnam (60%, n = 169/282) but the proportion of infections attributable to genotype 1 varied between regions and risk groups and, in the Southern part of Vietnam, genotype 6 viruses dominated in dialysis and multi-transfused patients (73.9%). This study confirms a high prevalence of HCV infection in Vietnamese IDUs and, notably, reveals high levels of HCV infection associated with dialysis and blood transfusion.
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Affiliation(s)
- Linda Dunford
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Michael J. Carr
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Jonathan Dean
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Allison Waters
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Linh Thuy Nguyen
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Thu Hong Ta Thi
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Lan Anh Bui Thi
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Huy Duong Do
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Thu Thuy Duong Thi
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Ha Thu Nguyen
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Trinh Thi Diem Do
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Quynh Phuong Luu
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Jeff Connell
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Suzie Coughlan
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Hien Tran Nguyen
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - William W. Hall
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
- * E-mail: (WWH); (LANT)
| | - Lan Anh Nguyen Thi
- Ireland Vietnam Blood-Borne Virus Initiative (IVVI), Dublin, Ireland and Ha Noi Vietnam
- Laboratory for Molecular Diagnostics, National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
- * E-mail: (WWH); (LANT)
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Grzegorzewska AE, Kaczmarek-Leki V, Młot-Michalska M, Niepolski L. Seroconversion rate to positivity for antibodies against core antigen of hepatitis B virus and duration of renal replacement therapy. Nephrol Dial Transplant 2010; 26:970-6. [PMID: 20732926 DOI: 10.1093/ndt/gfq499] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prevalence of total antibodies against core antigen (anti-HBc) of hepatitis B virus (HBV) is greater in longer dialysed patients, but there are no data indicating a relationship between the higher seroconversion rate to anti-HBc positivity and longer renal replacement therapy (RRT) vintage prior to seroconversion. Our aim was to evaluate the association between RRT duration and seroconversion to anti-HBc positivity. METHODS An incidence of anti-HBc was evaluated in 425 anti-HBc-negative intermittent haemodialysis (IHD) patients: Group I included patients who underwent first anti-HBc testing 31 days from first IHD session, and Group II or III included patients with RRT duration < 3 or ≥ 3 years, respectively. Anti-HBc testing was repeated every 6-12 months. Sex, age, RRT duration, anti-HCV, HCV RNA, ALT, ASP, GGT, full vaccination series against HBV with developed anti-HBs titre > 10 IU/L, hepatitis history and underlying kidney diseases were used as independent variables predicting seroconversion to anti-HBc positivity. RESULTS Seroconversion rate to anti-HBc positivity was 2.59, 2.12 and 2.44 episodes/100 patient-years in Group I (n = 174), II (n = 170) and III (n = 80), respectively. In the entire group, there were 15 seroconversions to anti-HBc and one seroconversion to HBsAg positivity. The only variable predicting seroconversion in all HBsAg-negative patients (n = 424) was the lack of full vaccination series against HBV with developed anti-HBs titre > 10 IU/L maintained during the study (β - 0.112, P = 0.04). CONCLUSIONS Seroconversion rate to anti-HBc positivity is not related to duration of RRT treatment but to ineffective vaccination against HBV.
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Affiliation(s)
- Alicja E Grzegorzewska
- Department of Nephrology, Transplantology and Internal Diseases, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.
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Paniagua R, Villasís-Keever A, Prado-Uribe MDC, Ventura-García MDJ, Alcántara-Ortega G, Ponce de Leon SR, Cure-Bolt N, Rangel-Frausto S. Elevated Prevalence of Hepatitis B in Mexican Hemodialysis Patients. A Multicentric Survey. Arch Med Res 2010; 41:251-4. [DOI: 10.1016/j.arcmed.2010.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 04/23/2010] [Indexed: 11/25/2022]
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van Hulst M, Hubben GAA, Sagoe KWC, Promwong C, Permpikul P, Fongsatitkul L, Glynn DM, Sibinga CTS, Postma MJ. Web interface-supported transmission risk assessment and cost-effectiveness analysis of postdonation screening: a global model applied to Ghana, Thailand, and the Netherlands. Transfusion 2009; 49:2729-42. [PMID: 19709093 DOI: 10.1111/j.1537-2995.2009.02351.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The goal of our research was to actively involve decision makers in the economic assessment of screening strategies in their region. This study attempted to accomplish this by providing an easy-to-use Web interface at http://www.bloodsafety.info that allows decision makers to adapt this model to local conditions. STUDY DESIGN AND METHODS The cost-effectiveness was compared of 1) adding antigen screening to antibody screening for hepatitis C virus (HCV) and human immunodeficiency virus (HIV); 2) adding nucleic acid amplification testing (NAT) on hepatitis B virus (HBV), HCV, and HIV in minipool (pool of 6 [MP6] and 24 [MP24]) to antibody screening and hepatitis B surface antigen (HBsAg) screening; and 3) individual-donation NAT on HBV, HCV, and HIV to antibody screening and HBsAg screening for Ghana, Thailand, and the Netherlands. RESULTS The combination of HCV antibody-antigen combination (combo) and HIV combo added to antibody screening in Ghana and Thailand was cost-effective according to the WHO criteria. MP24-NAT screening in Ghana was also cost-effective. MP24-NAT on HBV, HCV, and HIV was not cost-effective compared to the other screening strategies evaluated for the Netherlands. Large regional differences in cost-effectiveness were found for Thailand. CONCLUSION The young transfusion recipient population of Ghana in combination with a high risk of viral transmission yields better cost-effectiveness for additional tests. The advanced age of the transfused population of the Netherlands and a small risk of viral transmission gives poor cost-effectiveness for more sensitive screening techniques. It was demonstrated that a global health economic model combined with a Web interface can provide easy access to risk assessment and cost-effectiveness analysis.
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Affiliation(s)
- Marinus van Hulst
- Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
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Johnson DW, Dent H, Yao Q, Tranaeus A, Huang CC, Han DS, Jha V, Wang T, Kawaguchi Y, Qian J. Frequencies of hepatitis B and C infections among haemodialysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data. Nephrol Dial Transplant 2008; 24:1598-603. [PMID: 19096083 DOI: 10.1093/ndt/gfn684] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in peritoneal dialysis (PD) and haemodialysis (HD) patients in the Asia-Pacific region. METHODS The study included the most recent period-prevalent data recorded in the national or regional dialysis registries of the 10 Asia-Pacific countries/areas (Australia, New Zealand, Japan, China, Taiwan, Korea, Thailand, Hong Kong, Malaysia and India), where such data were available. Longitudinal data were also available for all incident Australian and New Zealand patients commencing dialysis between 1 April 1995 and 31 December 2005. Rates of HCV and HBV infections were compared by chi-square, Poisson regression and Kaplan-Meier survival analyses, as appropriate. RESULTS Data were obtained on 201,590 patients (HD 173,788; PD 27,802). HCV seroprevalences ranged between 0.7% and 18.1% across different countries and were generally higher in HD versus PD populations (7.9% +/- 5.5% versus 3.0% +/- 2.0%, P = 0.01). Seroconversion rates on dialysis were also significantly higher in HD patients (incidence rate ratio PD versus HD 0.33, 95% CI 0.13-0.75). HCV infection was highly predictive of mortality in Japan (relative risk 1.37, 95% CI 1.15-1.62, P = 0.003) and in Australia and New Zealand (adjusted hazards ratio 1.29, 95% CI 1.05-1.58). HBV infection data were limited, but less clearly influenced by dialysis modality. CONCLUSIONS Dialysis modality selection significantly influences the risk of HCV infection experienced by end-stage renal failure patients in the Asia-Pacific region. No such association could be identified for HBV infection.
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Affiliation(s)
- David W Johnson
- Australia and New Zealand Dialysis and Transplant Registry, Discipline of Public Health, University of Adelaide, Adelaide, Australia.
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Abstract
Prevention of nosocomial transmission of hepatitis B virus (HBV) has been a signal achievement in the management of chronic kidney disease. The rate of serum hepatitis B surface antigen (HBsAg) seropositivity in patients on maintenance hemodialysis in the developed world is currently low (0-10%) but outbreaks of acute HBV infection continue to occur in this setting. The prevalence of HBV infection within dialysis units in developing countries appears higher (2-20%) based on relatively few reports. Although data are limited, HBV infection in dialysis population diminishes survival; HBV viral load in HBsAg-positive dialysis patients is reportedly low and stable over time. Updated recommendations for the management of HBsAg chronic carriers on maintenance dialysis have been issued. No rigorously controlled treatment trials for treatment of hepatitis B with either interferon or lamivudine therapy in dialysis patients are currently available.
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Affiliation(s)
- Fabrizio Fabrizi
- Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS, Milan, Italy.
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