BACKGROUND: It has been hypothesized that hemodialysis (HD) treatment per se can preserve patients from an aggressive course of hepatitis C virus (HCV) infection by reduction of viral load. The aim of the present study in HCV-positive (HCV+) HD patients is to determine whether HD induces the production of interferon-alpha (IFN-alpha) and if such production can contribute to viremia reduction. METHODS: To address this issue, HCV RNA and IFN-alpha levels were determined in 11 HCV+ patients immediately before and at the end of a 4-hour dialysis session using cellulosic membranes and 24 and 48 hours later, ie, immediately before the subsequent dialysis session using the same membrane and at the end of the dialysis session. The same protocol was repeated 1 week later using a high-biocompatibility synthetic membrane. RESULTS: HCV titer decreased in all patients after dialysis (range, 3% to 95%; P = 0.001) and thereafter progressively increased and returned to basal levels within 48 hours, with a new reduction during the next dialysis treatment. There was no significant difference in the magnitude of changes in HCV titers in tests performed using cellulosic or synthetic membranes. Plasma IFN-alpha levels increased markedly after dialysis using both cellulosic (in 9 of 11 cases) and synthetic membranes (in 10 of 11 cases; P < 0.01) and returned to basal levels within 48 hours; thereafter, IFN-alpha levels increased again during the next dialysis session. In some patients, plasma IFN-alpha levels after HD were approximately 50% of the level observed after therapeutic administration of 6 million units of IFN-alpha to 4 HD patients with chronic hepatitis. CONCLUSION: Although without a proven direct cause-effect relationship between HCV level reduction and induction of IFN-alpha after dialysis, our observation suggests an additional new mechanism for the unusually mild course of HCV infection in HD patients.
BACKGROUND: It has been hypothesized that hemodialysis (HD) treatment per se can preserve patients from an aggressive course of hepatitis C virus (HCV) infection by reduction of viral load. The aim of the present study in HCV-positive (HCV+) HDpatients is to determine whether HD induces the production of interferon-alpha (IFN-alpha) and if such production can contribute to viremia reduction. METHODS: To address this issue, HCV RNA and IFN-alpha levels were determined in 11 HCV+ patients immediately before and at the end of a 4-hour dialysis session using cellulosic membranes and 24 and 48 hours later, ie, immediately before the subsequent dialysis session using the same membrane and at the end of the dialysis session. The same protocol was repeated 1 week later using a high-biocompatibility synthetic membrane. RESULTS:HCV titer decreased in all patients after dialysis (range, 3% to 95%; P = 0.001) and thereafter progressively increased and returned to basal levels within 48 hours, with a new reduction during the next dialysis treatment. There was no significant difference in the magnitude of changes in HCV titers in tests performed using cellulosic or synthetic membranes. Plasma IFN-alpha levels increased markedly after dialysis using both cellulosic (in 9 of 11 cases) and synthetic membranes (in 10 of 11 cases; P < 0.01) and returned to basal levels within 48 hours; thereafter, IFN-alpha levels increased again during the next dialysis session. In some patients, plasma IFN-alpha levels after HD were approximately 50% of the level observed after therapeutic administration of 6 million units of IFN-alpha to 4 HDpatients with chronic hepatitis. CONCLUSION: Although without a proven direct cause-effect relationship between HCV level reduction and induction of IFN-alpha after dialysis, our observation suggests an additional new mechanism for the unusually mild course of HCV infection in HDpatients.
Authors: Roberto J Carvalho-Filho; Ana Cristina C A Feldner; Antonio Eduardo B Silva; Maria Lucia G Ferraz Journal: World J Gastroenterol Date: 2015-01-14 Impact factor: 5.742
Authors: Jan Sperl; Sona Frankova; Renata Senkerikova; Magdalena Neroldova; Vaclav Hejda; Miroslava Volfova; Dusan Merta; Ondrej Viklicky; Julius Spicak; Milan Jirsa Journal: World J Gastroenterol Date: 2015-05-14 Impact factor: 5.742
Authors: Jose Eduardo Trevizoli; Raissa de Paula Menezes; Lara Franciele Ribeiro Velasco; Regina Amorim; Mauro Birche de Carvalho; Liliana Sampaio Mendes; Columbano Junqueira Neto; José Roberto de Deus Macedo; Francisco de Assis; Rocha Neves Journal: Clin J Am Soc Nephrol Date: 2008-07-23 Impact factor: 8.237
Authors: Edmundo Pessoa Lopes; Luis Henrique B C Sette; Jorge Bezerra C Sette; Carlos F Luna; Amaro M Andrade; Maviael Moraes; Paulo C A Sette; Roberto Menezes; Rui L Cavalcanti; Sergio C Conceição Journal: Clinics (Sao Paulo) Date: 2009 Impact factor: 2.365