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Saudi Journal of Kidney Diseases and Transplantation
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   1995| April-June  | Volume 6 | Issue 2  
    Online since May 22, 2008

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The Effect of Chemical and Heat Disinfection of the Hemodialysis Machines on the Spread of Hepatitis C Virus Infection: A Prospective Study
Hassan Abu-Aisha, Ahmed Mitwalli, Sameer O Huraib, Jamal Al-Wakeel, Jamal Abid, Kalthoum I Yousif, Farida Algayyar, Sami Ramia
April-June 1995, 6(2):174-178
Seventeen of our 42 regular hemodialysis (HD) patients (40.5%), and six of our 16 patients on continuous ambulatory peritoneal dialysis (CAPD) (37%) were found to be positive for hepatitis C virus (HCV) antibody in June, 1992. Since the virus was considered susceptible to eradication by the available disinfection methods of the HD machines, the most likely source of transmission was considered to be incomplete application of the universal infection control techniques. These recommendations were strictly applied, but no attempt was made towards designating specific machines for anti-HCV positive patients. Review of data revealed that seven of our 25 previously negative patients (28%) turned positive in the following 12 months. Risk factors such as blood transfusions were excluded in all these patients. A strict protocol of careful chemical disinfection using Citrosteril run at 85° C for 35 minutes after each dialysis session was adopted. Over the following 18 months, six of the remaining 17 negative patients (35.2%) seroconverted. They all had received blood transfusions, 7 to 14 months before (mean 10.5 months). The blood had been screened and had tested negative for anti-HCV antibody. By contrast, none of our CAPD patients who were anti-HCV negative in June 1992, and remained on CAPD, turned positive. The HD machine disinfection techniques were thoroughly reviewed and found to be as prescribed In the absence of other sources of infection with HCV we conclude that the HD machines were the most likely source of transmission of HCV infection and therefore, it is important to assign specific HD machines for anti­HCV positive patients. We have now adopted such a system.
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Liver Enzymes and Protein Electrophoretic Patterns in Hemodialysis Patients with Antibodies Against the Hepatitis C Virus
Mohammad Nageb Omar, Mohammad Amin Tashkandy, Ahmad Hisham El Tonsy
April-June 1995, 6(2):163-166
One hundred and forty nine patients with end-stage renal disease on regular hemodialysis were screened for antibodies against hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg). The overall prevalence of anti-HCV was 84.6%. All patients were examined for liver functions and serum protein electrophoretic patterns. A total of 23 patients (15.4%) were negative for both anti-HCV and HBsAg (Group I), 126 (84.6%) were positive only for anti-HCV (Group II), and 12 (8.1%) patients were positive for both anti-HCV and HBsAg (Group III). No significant correlation was noted between the elevation of liver enzymes and the groups studied. A significant increase in total proteins and gamma globulin levels were observed in Groups II and III in comparison with Group I (P < 0.05). Serum albumin levels were significantly decreased and alpha-1 and beta globulin levels were significantly increased in group III patients as compared to Groups I and II (P < 0.05). The finding of a significant increase in gamma globulin levels in Groups II and III as compared to Group I requires immunoglobulin typing, an observation being currently investigated.
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Hepatitis C Virus: Molecular Virology and its Implications for Serologic Diagnosis
Sami Ramia
April-June 1995, 6(2):190-196
Hepatitis C Virus (HCV) has been identified as the major etiological agent of parenterally-transmitted non-A non-B hepatitis. The virus has been cloned recently and completely or partially sequenced. Molecular analysis of the HCV genome indicates that it is a small, enveloped RNA virus having a highly conserved structural region followed by five less conserved non-structural regions. Based on nucleotide sequences, it has been found that multiple types of HCV exist. Infection with HCV can now be diagnosed by using virus-specific antibodies. A first generation enzyme-linked immunosorbent assay (ELISA) was initially used. However, this test had many drawbacks and consequently a second generation ELISA has been developed. The inclusion of new antigens in a recombinant immunoblot assay has further increased the sensitivity of diagnosing HCV infection. Also, detection of the virus genetic material by using polymerase chain reaction has enabled detection of viremia within only a few days following exposure apart from offering a possibility to monitor anti-viral treatment, since a decrease in viral RNA level is noticed in patients with positive response to treatment.
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Hepatitis C Virus Infection Among Dialysis Patients in United Arab Emirates
Yassin I El Shahat, Shakunthala Varma, M Zahir Bari, M Shah Nawaz, Salim Abdulrahman, Avinash Pingle
April-June 1995, 6(2):157-162
To evaluate the incidence of positivity of anti-hepatitis C virus (anti-HCV) antibodies in the hemodialysis (HD) patients, and the impact of isolation of the anti-HCV positive patients, we studied 262 HD patients in our unit between January 1991 and December 1993. There were 64 patients with anti-HCV positivity. Forty nine of them were males, and 15 were females, with mean ages of 41.8 ± 8.6 years. The mean dialysis period was 20.9 ± 2.5 months. The serum anti-HCV antibodies were detected with second generation HCV enzyme linked immunosorbent assay. The test was repeated every three months for the patients, and every six months for the dialysis staff members. Dialyzers were not reused. Isolation of the positive patients by using designated HD machines was performed, besides adopting the universal precautions of infection. At the time of the inclusion to the study 45 patients out of 64 (70.3%) were anti-HCV positive. In this group 42% received blood transfusions, 17.5% started hemodialysis in another dialysis unit. Nineteen patients (29.7%) seroconverted during the study period. In this group, nine patients (47.6%) received blood transfusions (1.7 + 0.5 units). Of the seroconverted patients, eight (42%) travelled abroad and received HD during their holidays. Eight of the seroconverted patients did not have identifiable risk factors except HD. The overall seroconversion rate was 0.95 per 100 patient months. The rate decreased to 0.4 per 100 patient months if the identifiable causes for seroconversion (blood transfusion, duration of dialysis, holiday dialysis) were excluded. We conclude that HCV infection is frequent in hemodialysis patients. Strict follow up of the universal precautions together with isolation of anti-HCV positive patients with designated machines may be sufficient to prevent nosocomial transmission of HCV infection. The risk of transfusion may be minimized by using r-Human erythropoietin in the treatment of anemia in this population.
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Hepatitis C in Dialysis Patients
Sameer O Huraib
April-June 1995, 6(2):197-205
Hepatitis C virus (HCV) infection is a major health problem in hemodialysis patients. Identified risk factors include duration on dialysis and blood transfusion. A more important risk factor contributing to the high prevalence of anti-HCV, particularly in the developing countries, could be the non-adherence to the known universal infection control precautions. The factors that might help reduce and/or prevent the spread of HCV infection among patients on dialysis include: early screening of patients for anti-HCV, reduction of the number of blood transfusions given, strict application of universal infection control precautions and isolation of patients or machines which ever feasible. The issue regarding isolation of anti-HCV positive patients is controversial and although it is not recommended by the Centers for Disease Control to isolate these patients, it may be advisable to do so, particularly in the developing countries, wherein a high prevalence of anti-HCV exists among the dialysis population.
  2,117 283 -
Hepatitis C Virus Infection in Hemodialysis Patients in Jordan
Riyad A Said, Yousef Y Hamzeh, Nabil S Mehyar, Mohamed S Rababah
April-June 1995, 6(2):140-143
To evaluate the prevalence of hepatitis C virus infection in our hemodialysis population, we carried out a survey of 273 adult hemodialysis patients in three hemodialysis units in Jordan using a second generation rapid enzyme immunoassay. Sixty seven patients were seropositive with a prevalence of 24.5%. All patients were transfusion dependent except two. More than 85% of the patients have been on hemodialysis for more than two years. Co-infection with hepatitis B virus was observed in six patients. Abnormal liver functions were seen in five patients, but liver biopsies were not done. The prevalence of hepatitis C antibody in healthy blood donors in Jordan is 1.7%. We conclude that HCV infection prevalence in hemodialysis patients in Jordan is 24.5%, a percentage similar to what has been reported around the world and in the neighboring countries.
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Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan
Salma M Suliman, Solomon Fessaha, M El Sadig, M Babiker El-Hadi, Stephen Lambert, Howard Fields, Hashim W Ghalib
April-June 1995, 6(2):154-156
To estimate the prevalence of positivity of hepatitis C virus (HCV) antibodies in the hemodialysis population in Sudan and the risk factors of this infection in them we studied 46 hemodialysis patients (34 males, 12 females) in the Khartoum Kidney Dialysis Center (KKDC) in December 1994. Also we studied 37 healthy staff members in that unit. The blood of both groups was screened for HCV antibodies using a second generation ELISA test and confirmed by two bead supplemental assays. In the patients group, 16 cases (34.9%) were confirmed seropositive for HCV. There was a history of jaundice in four them. The mean duration on dialysis was 3.28 years in the HCV seropositive group compared with 2.2 years in the HCV seronegative group (P < 0.05). The mean frequency of blood transfusion was 2.68 units of blood in the HCV seropositive group, while it was 3.16 units in the HCV seronegative group which was not significantly different. Only two patients had high liver enzymes in the HCV seropositive groups, while there were seven patients with high liver enzymes in the HCV seronegative group. There were two staff members (5.41%) with positive HCV antibodies, but none had a history of jaundice or elevated liver enzymes. Both staff members were not involved in the direct patients care. We conclude that the prevalence of HCV antibody positivity was high in the hemodialysis population in Sudan. Nosocomial transmission may be the factor of transmission since we found no correlation with the blood transfusions.
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Prevalence of Antibodies Against the Hepatitis C Virus Among Voluntary Blood Donors at a Makkah Hospital
Mujahid Shakil Ahmad, Alam Mohammad Mahtab, Al Shaibi Abdullatif, Mohamad Amin Tashkandy, Mohammad Shehab Al-Deen Kashreed, Abdulraheem Maulana
April-June 1995, 6(2):122-124
One thousand four hundred and thirty nine voluntary blood donors attending the blood transfusion department at Al Noor Specialist Hospital, Makkah were screened for antibodies against hepatitis C virus (anti-HCV) by second generation enzyme linked immunosorbant assay (ELISA). A total of 52 donors (3.6%) were anti-HCV positive. Anti-HCV was detected in 1.7% of the Saudi donors as compared to 6.9% among Non-Saudi donors. Scrutiny of the data revealed a higher rate of anti-HCV in the age-group of above 40 years than in the other age groups. Further, when Non-Saudi blood donors were analysed according to their nationalities, Egyptian donors showed a prevalence of 27.2% of anti-HCV followed by Pakistanis (1.9%), Bangladeshis (1.9%), Yemenis (1.5%) and other nationalities (0.5%). When blood samples from 92 patients on maintenance hemodialysis were tested for anti-HCV, 75 (81.5%) patients were found positive for anti-HCV. We conclude that the prevalence of anti-HCV among blood donors in the Makkah region of Saudi Arabia is high and routine screening for anti-HCV should be conducted for all blood donors before they are accepted for donation.
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The Annual Incidence of Seroconversion of Antibodies to the Hepatitis C Virus in the Hemodialysis Population in Saudi Arabia
Muhammed Ziad Souqiyyeh, Faissal A.M Shaheen, Sameer O Huraib, Abdullah A Al-Khader
April-June 1995, 6(2):167-173
A mail survey was conducted involving 102 hospital-based active hemodialysis (HD) centers in Saudi Arabia to assess the annual incidence of seroconversion of antibodies against the hepatitis C virus (HCV). Tests for anti-HCV, using second generation ELISA, were performed every three months on the study subjects for a period between January 1993 to December 1994. Response was received from 73 centers (72%) on 1,392 patients and from 61 centers (60%) on 694 staff members. Of the study patients, 733 (52.7%) were males, and 659 (47.3%), females; 1,093 (78.5%) were Saudis, while 299 (21.5%) were Non-Saudis. The mean age of the patients was 44.5 ± 14.3 years (range 10-75 years). The mean duration on HD was 3.1 + 2.1 years (range 3 months - 10 years). Reuse of the dialyzers was not practiced on any of the study patients. During the study period, 28% of the patients did not receive any blood transfusions while the remaining 72% received varying number of transfusions. The average prevalence of anti-HCV among HD patients was 70%,and among the dialysis staff was 1%. and the annual rate of serconversion was 7% to 9%. The anti-HCV seroconversion rate was significantly lower in the dialysis centers with more than 20 patients compared with the smaller dialysis centers (P< 0.0001). Also, there was a significant correlation between increased rates of seroconversion and duration on HD as well as with history of blood transfusions (P< 0.001). There were no significant differences in the rates of anti-HCV seroconversion related to the sex, age or nationality of the patients. There was no correlation between the elevation of liver enzymes or presence of HBV infection and the annual rate of seroconversion. We conclude that the annual incidence of the seroconversion of anti-HCV in the HD population in Saudi Arabia is 7-9% and isolation of the anti-HCV positive patients may help in decreasing this incidence.
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Prevalence of Hepatitis C Antibodies Among Hemodialysis Patients in the Western Province of Saudi Arabia
Faissal A.M Shaheen, Sameer O Huraib, Rashed Al-Rashed, Abdulatif Aldrees, Mohammad Arif, Mohammad Al Jeffry, Mohammad Amin Tashkandy, Mohamad Safwat
April-June 1995, 6(2):136-139
We studied 408 patients on maintenance hemodialysis at four different centers in the Western province of Saudi Arabia to assess the prevalence of antibody against Hepatitis C Virus (HCV) and the possible risk factors. There were 212 males and 196 females with a mean age of 42.9 ± 13.9 years (range 12 to 75 years). They were on dialysis for a period between 3 to 140 months with a mean of 52.2 + 38 months. Assay for anti-HCV was made by second generation ELISA. A total of 295 patients (72.3%) tested positive. The prevalence rates varied considerably among the four centers studied and were as follows: the center at Jeddah, 62.7%; two centers at Makkah, 87% and 79.7% respectively and one center at Taif, 80.9%. A total of 311 patients had received varying number of blood transfusions. Of these, 230 (74%) were anti-HCV positive as against 97 patients who were never transfused of whom 65 (67%) were positive. This difference did not reach statistical significance (P = 0.22). Similarly, we found no significant correlation between the anti-HCV prevalence rates and serum alanine transaminase levels (P = 0.93). Our study further confirms that there are routes other than blood transfusion involved in the transmission of the HCV and there is a need to determine these routes in order to prevent the spread of this virus.
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The Prevalence of Hepatitis C Virus Antibodies Among Hemodialysis Patients in Jeddah Area, Saudi Arabia
Saad S Al Shohaib, Mohamed A Abdelaal, Tarif H Zawawi, Fatima M Abbas, Faissal A.M Shaheen, Essife Amoah
April-June 1995, 6(2):128-131
The prevalence of antibody to hepatitis C virus (HCV) in hemodialysis (HD) patients is high and variable. One hundred and thirty nine patients undergoing maintenance HD at three different renal units in Jeddah, Kingdom of Saudi Arabia, were studied for prevalence of anti-HCV antibody. The overall prevalence in the group examined was 52.5% (73/139). There was a significant correlation between prevalence of anti-HCV and duration of HD; 53/ 74 (71.6%) in patients on HD for > 3 years as against 20/65 (30.8%) for patients on HD for < 3 years (P< 0.05). We were unable to demonstrate a correlation of anti-HCV positivity with history of blood transfusions, previous exposure to hepatitis-B virus, sex, age, or ethnic group. The very high prevalence of anti-HCV found in patients on maintenance HD and the positive correlation between anti-HCV reactivity and duration on dialysis suggest that factors within the dialysis unit might contribute to the spread of the virus.
  1,713 239 -
Hepatitis C Virus Infection in a Hemodialysis and Kidney Transplant Patient: An Eight Year Follow-up Report
Khalid Al Meshari, Nasrulla Abutaleb, Osman I Alfurayh, Mohammed Ashraf Ali
April-June 1995, 6(2):211-215
We report our experience in the management of a hemodialysis (HD) patient who acquired hepatitis C virus (HCV) infection while on dialysis, and subsequently received a kidney transplant. The potential role of alpha-interferon in the management of HCV infection is discussed, as well as the potential for azathioprine to perpetuate HCV induced liver disease following kidney transplantation. The management of this patient summarizes our standard practice for the management of HCV infection during HD and following kidney transplantation.
  1,720 197 -
Impact of Hepatitis C Virus Infection on Kidney Transplant Outcome
Osman I Alfurayh, Mohamed A.E Sobh, Tariq S Chaudry, Wajeh Y Qunibi, Khalid Al Meshari, Michael Ellis, Mohamed A Ali, Saadi Taher
April-June 1995, 6(2):183-189
One hundred and forty kidney transplant recipients were evaluated to study the impact of hepatitis C virus (HCV) infection on patient and graft outcome. There .were 98 males arid 42 females with a mean age of 32.1 ± 13 years. The duration of follow-up ranged from 6-60 months with a mean period of 27.8 ± 18.2 months. Seventy-four (53%) patients had received cadaveric kidneys while 66 (47%) received living donor grafts. Anti-HCV reactivity was tested using second generation enzyme-linked immunosorbent assay and positivity was confirmed by recombinant immunoblot assay. HCV infection was diagnosed in 29 cases (20.7%) while HBsAg was found in nine (6.4%) and concomitant anti-HCV and HBsAg positivity was observed in two patients (1.4%). Seventeen of 29 (58.6%) patients with anti-HCV reactivity showed elevated ALT levels as against 17 of 111 (17.3%) anti-HCV non-reactive patients (P<0.001). There was no association between the sex of the patient, source of the graft, and anti-HCV reactivity. Serum creatinine values were higher in the anti-HCV positive group, but this did not rank to statistical significance. We observed a significantly higher graft loss among the anti-HCV reactive group (27.6% versus 1.8%, P< 0.003). Thirteen anti-HCV reactive patients were subjected to 18 liver biopsies; the commonest lesion observed was chronic active hepatitis, which was progressive in two patients subjected to re-biopsy. We conclude that HCV infection is a serious health problem among kidney transplant recipients and it significantly affects the graft outcome.
  1,732 175 -
Prevalence of Hepatitis C Virus Antibodies in Hemodialysis Patients in Madinah Al Munawarah
Bassam Bernieh, Mohamed Allam, Asma Halepota, Abdulrahman Osman Mohamed, Jameel Parkar, Ahmad Tabbakh
April-June 1995, 6(2):132-135
This study was carried out to evaluate the prevalence of antibodies against hepatitis C virus (HCV) in our hemodialysis (HD) unit at Madinah Al Munawarah in Saudi Arabia. Fifty six of the 94 patients (60%) studied were positive for HCV, while none of the thirty staff members working in the same unit were positive. The positivity of HCV correlated significantly with duration on HD. No significant correlation was found with the number of blood transfusions, hepatitis B markers or liver enzymes.
  1,658 216 -
Hepatitis C Virus Infection in Patients on Maintenance Dialysis in Kuwait: Epidemiological Profile and Efficacy of Prophylaxis
Kamel El-Reshaid, Madan Kapoor, Thattuparambil Sugathan, Siham Al-Mufti, Nabih Al-Hilali
April-June 1995, 6(2):144-150
Data on hepatitis C virus (HCV) infection in patients undergoing maintenance hemodialysis (HD) in Kuwait were collected retrospectively in December 1994. Ninety three of 232 patients (40%) studied had hepatitis C antibodies (anti-HCV) when tested by a second generation enzyme linked immuno-sorbent assay (ELISA-II). Since October 1992, all HD patients who tested positive for anti-HCV were dialysed on separate machines and blood transfusions were limited to acute life-threatening emergencies through regular use of recombinant human erythropoeitin. The prevalence of anti-HCV positivity among dialysis patients who received treatment during the "HCV-prophylaxis period" was 33/163 (20.2%), as compared to 46/55 (83.6%) of those who received HD during the 27 months prior to October 1992 (p< 0.0001), and had similar average duration on dialysis (12 + 7 and 13 + 7 months, respectively). Excluding the 15 patients who had anti-HCV on entry to HD during "HCV­prophylaxis period", the estimated incidence of positive anti-HCV seroconversion was 11.5 per 100 patients per year on HD. In the 93 anti-HCV positive patients, alanine aminotransferase (ALT) levels were elevated for more than six months in 32 (34.4%), elevated in multiple peaks in 22 (23.7%) and showed combined variation of the latter two abnormalities in 16 (17.2%). Histological evidence of chronic active hepatitis was present in five of six patients who manifested persistent ALT abnormalities. Vaccination against hepatitis B virus produced positive seroconversion in 76.1% patients, and those with positive anti-HCV were not at a disadvantage. In conclusion, HCV infection is common in patients undergoing HD in Kuwait.Improvement in screening assays, isolation of anti-HCV positivepatients during dialysis and limitation of blood transfusions may decrease the transmission of this disease in this patient population.
  1,604 254 -
Hepatitis C Virus Infection: An Update
Faleh Zaid Al-Faleh
April-June 1995, 6(2):118-121
Hepatitis C virus (HCV) infection is widely prevalent world-wide particularly in high-risk individuals including patients on hemodialysis (HD). Parenteral route seems to be the main route of transmission of this infection though other routes also exist. The high prevalence of HCV infection in patients on HD who have never received blood transfusions points to the dialysis machine as one of the likely sources of transmission of infection. The reported prevalence of anti­HCV in patients on HD in Saudi Arabia is about 68%. The natural history of HCV shows a tendency to progress to chronic liver disease including chronic active hepatitis, cirrhosis and hepatocellular carcinoma. The prevalence of anti-HCV in the general population varies from 0.5 to 3% and thus vigorous screening should be applied to all potential blood donors. A policy of public health education should be designed and implemented on the general public and health workers to reduce the non-parenteral spread of HCV. Separate HD machines should be considered for patients who are anti-HCV positive. Such preventive measures are vital because treatment of HCV with interferon has met with mixed success so far.
  1,520 228 -
Hepatitis C Associated Chronic Liver Disease in Renal Transplant Recipients
Abdalla H Abdalla, Mohamed H Al Sulaiman, Dujana H Mousa, Zalmai Rassoul, Mohamed Abdul Rahman, Abdullah A Al-Khader
April-June 1995, 6(2):179-182
Infection with Hepatitis C Virus (HCV) is emerging as a major cause of morbidity and mortality in renal transplant recipients. We studied three hundred and forty stable renal transplant recipients on follow-up in our transplant clinic. Anti-HCV, tested by second generation ELISA, was positive in 185 patients (54%) of whom 52 (28%) had evidence of chronic liver disease. Six of the study patients were positive for anti-HCV and hepatitis B surface antigen. Twenty-three patients consented to undergo liver biopsy of whom eight had normal histology or fatty changes. Five patients had chronic non-specific hepatitis; four each had chronic lobular and chronic active hepatitis (CAH) and two had CAH with cirrhosis. All 15 patients with significant abnormalities on liver histology had elevated serum transaminase levels. Repeat liver biopsies were performed in seven patients after a mean period of 23.8 months following the first biopsy which showed worsening of the disease in four while three retained the same pattern. These results suggest that the prevalence of anti-HCV in our renal transplant recipients is high and that these patients have a high prevalence of chronic liver disease associated with major changes on liver histology. It is therefore recommended that caution is exercised while considering transplantation in patients who are anti-HCV positive.
  1,516 195 -
Hepatitis C Virus Infection in Hemodialysis Patients in Qatar
Omer Abboud, Awad Rashid, Saad Al-Kaabi
April-June 1995, 6(2):151-153
To evaluate the prevalence of hepatitis C virus (HCV) infection and the histopathological aspects of this infection among regular hemodialysis patients, we followed 130 patients on regular dialysis screened for HCV antibodies by enzyme-linked immunosorbent assay (ELISA). Confirmatory testing was done using a second generation recombinant immunosorbant assay (RIBA). Fifty eight patients (44.6%) were antibody positive at the start of the study. There was a significant relationship between the presence of anti-HCV antibody and the increased period on dialysis (54.3 months in the sero-positive group, compared to 22.2 months in the sero­negative group, (P < 0.001). There was no statistical correlation with the history of blood transfusion or the serum iron level. Liver biopsies in eight sero-positive patients with abnormal liver enzymes showed chronic active hepatitis in six and chronic persistent hepatitis in two cases. Such findings of gross hepatic involvement in anti-HCV positive hemodialysis patients strongly support the arguments for antiviral therapy with Interferon in these patients, in the attempt to prevent further hepatic damage, before they receive renal allografts.
  1,447 229 -
Progression of Hepatitis C Infection in a Renal Transplant Recipient: A Case Report
Abdalla H Abdalla, Dujana H Mousa, Zalmai Rassoul, Fahad Al Hawas, Mohamed H Al Sulaiman, Abdullah A Al-Khader
April-June 1995, 6(2):206-210
We present a patient with hepatitis C virus (HCV) infection who developed chronic active hepatitis (CAH) after renal transplantation. Alpha-interferon (a-IF) therapy was administered in view of deteriorating liver biochemistry. Liver histology at this stage showed features suggestive of chronic active hepatitis (CAH). The patient had stable graft function. Therapy with a-IF resulted in noticeable biochemical response within two weeks of commencement. An episode of steroid resistant renal allograft rejection occurred after 10 weeks of a-IF therapy which responded well to anti-lymphocyte globulin. Since then, the CAH has gradually progressed on to the development of cirrhotic changes and hepato-cellular carcinoma after 10 years following transplantation. Our case indicates that liver disease in anti­HCV positive patients can follow a serious course following renal transplantation.
  1,430 181 -
Hepatitis C Virus Infection Among Hemodialysis Patients in the Eastern Region of Saudi Arabia
Fahad A Al-Muhanna
April-June 1995, 6(2):125-127
The prevalence of anti-HCV antibodies among hemodialysis patients in the Eastern region of Saudi Arabia was 42.8%. This is comparable to the observations from the Central region of the country. Repeated blood transfusions of non-screened HCV blood seems to be the major factor responsible for this high prevalence. Clinical liver disease was infrequent in the early phase of the infection.
  1,214 210 -
Hepatitis C Infection: The Subject of this Issue
Abdullah A Al-Khader
April-June 1995, 6(2):115-117
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