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

Recommendations for the clinical management of hepatitis C in Iran: A consensus-based national guideline

Context: Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran. Evidence Acquisition: The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, ScopusandWeb of Science. Expert opinionwasbasedonthe consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rd national consensus on management of Hepatitis C in Iran, held on 22nd of July 2016. Results: Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. InHCVgenotype 1 and 4, DCV/SOF and LDV/SOF are recommended. InHCVgenotype 2, SOF plus RBV and inHCVgenotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered. Conclusions: Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection