Prevalence of occult HCV infection in hemodialysis and kidney-transplanted patients: A systematic review

peer reviewedAim: We performed a systematic review for determining the prevalence rate of occult HCV infection (OCI) among hemodialysis and kidney-transplanted (KT) patients. Methods: Electronic databases were searched with appropriate search strategies. We considered positive result for tests of HCV-RNA in peripheral blood mononuclear cell, ultracentrifuged serum or hepatocytes in the absence of HCV-RNA and anti-HCV antibody in patients' sera as the definition of OCI. Results: Two studies reported OCI prevalence rate of 0 and 2% among KT patients. Results of OCI prevalence rates among hemodialysis patients varied between 0 and 45% in ten different included studies showing a great heterogeneity. Conclusion: Although we still need more evidence to support our results, they suggest that checking OCI in hemodialysis or KT patients with unexplained signs of liver diseases may have some benefit

Acute pancreatitis induced by mycophenolate mofetil in a kidney transplant patient

Acute pancreatitis is a rare life-threatening complication in patients after kidney transplantation. Here we described a 56-year-old man who had received a living related kidney transplant for an end-stage renal disease. In his regular follow-up, his serum creatinine was gradually increased and he underwent an allograft biopsy, which revealed an interstitial nephritis/tubular atrophy grade II. Mycophenolate mofetil (MMF) was prescribed to control chronic allograft nephropathy. He presented with complaints of severe abdominal pain, vomiting, loss of appetite and fever requiring hospital admission twelve days later. Acute pancreatitis was diagnosed on the basis of laboratory data and imaging findings during hospital admission. There was no history of alcohol consumption in our patient. Unfortunately he died one week later and autopsy findings demonstrated acute necrotizing pancreatitis. The bladder drainage of this patients was normal. Laboratory findings in this patient did not endorse infections and other possibilities regarding the etiology of acute pancreatitis in this patient. Therefore, we concluded that acute pancreatitis in near the patient was induced by drugs and basis on our evidence, MMF is the most important suspect. This study suggests that acute pancreatitis can be considered as a side effect of MMF

Occult HCV Infection: The Current State of Knowledge.

[en] CONTEXT: Occult HCV infection (OCI) is defined as the presence of HCV-RNA in hepatocytes and the absence of HCV in the serum according to usual tests. We aimed to define OCI and provide information about the currently available diagnostic methods. Then we focus on specific groups that are at high risk of OCI and finally investigate immune responses to OCI and the available treatment approaches. EVIDENCE ACQUISITION: PubMed, Scopus and Google Scholar were comprehensively searched with combination of following keywords: "occult", "hepatitis C virus" and "occult HCV infection". The definition of OCI, diagnostic methods, specific groups that are at high risk and available treatment approaches were extract from literature. An analysis of available articles on OCI also was done based on Scopus search results. RESULTS: OCI has been reported in several high-risk groups, especially in hemodialysis patients and subjects with cryptogenic liver disease. Furthermore, some studies have proposed a specific immune response for OCI in comparison with chronic hepatitis C (CHC). CONCLUSIONS: With a clinical history of approximately 11 years, occult HCV infection can be considered an occult type of CHC. Evidences suggest that considering OCI in these high-risk groups seems to be necessary. We suggest that alternative diagnostic tests should be applied and that there is a need for the participation of all countries to determine the epidemiology of this type of HCV infection. Additionally, evaluating OCI in blood transfusion centers and in patients who receive large amounts of blood and clotting factors, such as patients with hemophilia, should be performed in future projects

Additional file 1: of Combination of sofosbuvir, pegylated-interferon and ribavirin for treatment of hepatitis C virus genotype 1 infection: a systematic review and meta-analysis

Appendix. Search strategies. (DOC 26 kb

Prevalence of occult HCV infection in hemodialysis and kidney-transplanted patients: a systematic review

peer reviewedAim: We performed a systematic review for determining the prevalence rate of occult HCV infection (OCI) among hemodialysis and kidney-transplanted (KT) patients. Methods: Electronic databases were searched with appropriate search strategies. We considered positive result for tests of HCV-RNA in peripheral blood mononuclear cell, ultracentrifuged serum or hepatocytes in the absence of HCV-RNA and anti-HCV antibody in patients' sera as the definition of OCI. Results: Two studies reported OCI prevalence rate of 0 and 2% among KT patients. Results of OCI prevalence rates among hemodialysis patients varied between 0 and 45% in ten different included studies showing a great heterogeneity. Conclusion: Although we still need more evidence to support our results, they suggest that checking OCI in hemodialysis or KT patients with unexplained signs of liver diseases may have some benefit