article information

Nephro-Urology Monthly: Vol.9, issue 6; e59941
published online: July 14, 2017
article type: Letter
received: March 18, 2017
accepted: May 6, 2017
DOI: https://doi.org/10.5812/numonthly.59941
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Chronic Hemodialysis Patients; Special Group for Hepatitis C Elimination Programs in Iran

authors:

avatar Hamidreza Karimi-Sari 1 , 2 , 3 , avatar Seyed Moayed Alavian ORCID 2 , 3 , *

Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Middle East Liver Disease (MELD) Center, Tehran, Iran

how to cite: Karimi-Sari H, Alavian S M. Chronic Hemodialysis Patients; Special Group for Hepatitis C Elimination Programs in Iran. Nephro-Urol Mon. 2017;9(6):e59941. https://doi.org/10.5812/numonthly.59941.

Dear Editor,

Recently world health organization (WHO) announced a global program to eliminate Hepatitis C virus (HCV) in the era of new direct acting antiviral drugs (DAAs) by 2030 (1). Finding and curing infected patients seems to be the most important step to reach the goal of HCV elimination (2). Iran has been categorized as a low endemicity country and prevalence of HCV infection is less than 0.5% in the general population (3). Of the 162 chronic hemodialysis patients (CHD), 11 patients (6.8%) had HCV infection in a study by Makhlough et al., which has been published recently in your journal (4). The prevalence of HCV infection was 10 times more than the general population of Iran in patients with CHD of Makhlough et al. study. Since mass-screening of the general population for HCV infection is not cost-effective, screening people with higher risk of HCV infection should be considered as a priority. Thus patients undergoing CHD seem to be a special group for HCV elimination in Iran.

Recent studies also showed that new DAAs are well-tolerated in CHD patients with sustained virological response (SVR) rate of up to 100% (5, 6). Today, accurate and low-cost generic DAAs are generally available in Iran (7). Also treating HCV infection is strongly recommended before kidney transplantation to increase the patients’ survival (8). Infection with HCV was associated with all-cause mortality in a large cohort of patients with CHD (9).

The study of Makhlough et al. also showed that HCV-Antibody (HCV-Ab) does not have enough accuracy for HCV screening in patients with CHD (4). Hence, real-time polymerase chain reaction (PCR) to find HCV-RNA should be considered for HCV screening in patients with CHD.

Finding and curing HCV infected cases among CHD patients should be considered as a priority to reach the goal of HCV elimination and increase their survival.

References

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    Lancet T. Towards elimination of viral hepatitis by 2030. Elsevier; 2016.

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    Hesamizadeh K, Sharafi H, Rezaee-Zavareh MS, Behnava B, Alavian SM. Next Steps Toward Eradication of Hepatitis C in the Era of Direct Acting Antivirals. Hepat Mon. 2016;16(4):37089. [PubMed ID: 27275164]. https://doi.org/10.5812/hepatmon.37089.

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    Mirminachi B, Mohammadi Z, Merat S, Neishabouri A, Sharifi AH, Alavian SH. Update on the prevalence of hepatitis c virus infection among iranian general population: A systematic review and meta-analysis. Hepat Mon. 2017;17(2).

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    Alavian SM, Hajarizadeh B, Bagheri Lankarani K, Sharafi H, Ebrahimi Daryani N, Merat S, et al. Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline. Hepat Mon. 2016;16(8):40959. [PubMed ID: 27799966]. https://doi.org/10.5812/hepatmon.guideline.

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    Einollahi B, Alavian SM. Hepatitis C virus infection and kidney transplantation: a review for clinicians. Iran J Kidney Dis. 2010;4(1):1-8. [PubMed ID: 20081297].

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    Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, Miller LG, Daar ES, Gjertson DW, et al. Hepatitis C virus and death risk in hemodialysis patients. J Am Soc Nephrol. 2007;18(5):1584-93. [PubMed ID: 17429053]. https://doi.org/10.1681/ASN.2006070736.