Many physicians treating hemodialysis (HD) patients seem not to be aware of the possibility that their patients might also suffer from hepatitis C (HCV).
Figures show that the disease is only rarely treated, warns a team of US-American, Belgian and Japanese researchers (Goodkin DA et al, Mortality, Hospitalization, and Quality of Life among Patients with Hepatitis C Infection on Hemodialysis; Clin J Am Soc Nephrol 2017;12:287-297).
The present prospective cohort study should serve as an eye-opener. Among the study cohort, HCV had a prevalence of 7.5 % and was associated with a higher risk of death and hospitalization and a worse quality of life. However, only 1.5 % of HCV-positive patients in this study received adequate anti-HCV treatment.
The study sought to understand the effects of treatment with sofosbuvir-containing therapies on people requiring hemodialysis. Hemodialysis is a process of filtering the blood of a person when the kidneys are not working normally. This was a prospective study. Patients received sofosbuvir once daily (7 patients) or 3 times a week (5 patients) after hemodialysis treatment. Sofosbuvir was given with either simeprevir, daclatasvir, ledipasvir or ribavirin.
It was found that all of the patients tolerated the medications. Two relapses occurred in the 3 times a week group but no one relapse in the daily group.
It was found that sofosbuvir could be safely administered but that close monitoring should be given to hemodialysis patients. They also noted that more data is needed to safely and effectively treat hemodialysis patients.
HCV liver disease progression can increase the risk of severe kidney disease progression. It is important to have effective therapies to treat hepatitis C that are safe for people with severe kidney disease. In clinical trials, Zepatier was shown to be safe and effective in people with kidney disease and hepatitis C. Until more clinical studies are conducted on sofosbuvir containing therapies, Zepatier is a safe alternative to sofosbuvir containing therapies for people on hemodialysis.
ATLANTA, Jan. 27 (UPI) — The Centers for Disease Control and Prevention is asking dialysis providers to improve their infection control practices because of an increased number of patients acquiring the hepatitis C virus.
The agency reports it has been contacted about 36 cases of HCV at 19 clinics in eight states, with transmission of the virus between patients proven at nine of the clinics. The transmission is being blamed on lapses in preventive measures such as injection safety, environmental disinfection, and hand hygiene.
HCV is a liver infection generally spread by sharing needles or other methods of injecting drugs. Most people who get HCV are infected for a short period of time, though it can lead to longer-term health problems.
Recent data confirmed that hepatitis C virus was transmitted to several patients at a dialysis clinic during a 6-year duration, underscoring the importance of aggressive infection control measures.
“Hepatitis C virus (HCV) infection is several times more prevalent among hemodialysis patients than the general U.S. population,” CDC researchers wrote. “Outbreaks of new HCV infections have been reported in U.S. dialysis centers, typically associated with lapses in infection control (IC), including improper parenteral medication handling and preparation, inadequate cleaning and disinfection of environmental surfaces between patient treatments and poor hand hygiene and glove use.”
During an epidemiologic investigation, the researchers evaluated HCV test results of all patients treated at an outpatient hemodialysis clinic in Philadelphia from January 2008 through April 2013. HCV tests were performed at admission and then annually for patients deemed susceptible to infection. All patients also underwent monthly screening for serum alanine aminotransferase (ALT); those with elevated ALT were tested for HCV antibodies.