Management of hepatitis C virus infection in hemodialysis patients

Table 1 Prevalence of anti-hepatitis C virus seropositivity in hemodialysis patients

Country/region	Prevalence	Investigators and year of publication
Slovenia	1.9%	Buturović-Ponikvar[12], 2001
Netherlands	3.4%	Schneeberger et al[13], 1999
Puerto Rico	3.5%	López-Navedo et al[14], 1999
United Kingdom	4.0%	Wreghitt[15], 1999
Germany	6.1%	Hinrichsen et al[16], 2002
Mexico	6.7%	Méndez-Sánchez et al[17], 2004
Belgium	6.8%	Jadoul et al[18], 2004
United States	7%-23.3%	Kalantar-Zadeh et al[5], 2007
		Kalantar-Zadeh et al[19], 2005
		Sivapalasingam et al[20], 2002
		Kelley et al[21], 2002
		Saab et al[22], 2001
Brazil	6%-90%	da Silva et al[4], 2013
		Mello Lde et al[23], 2007
		Lopes et al[24], 2006
		Albuquerque et al[25], 2005
		Carneiro et al[26], 2001
China Maintain	7.01%-37.34%	Ren et al[27], 2011
		Qi et al[28], 2003
Greece	10%-29%	Garinis et al[29], 1999
		Rigopoulou et al[30], 2005
		Sypsa et al[31], 2005
Sweden	11.0%	Almroth et al[32], 2002
Iran	13.2%	Alavian et al[33], 2003
France	16.3%	Salama et al[34], 2000
Tunisia	19%-41.7%	Bouzgarrou et al[35], 2005
		Ayed et al[36], 2003
Libya	20.5%	Daw et al[37], 2002
Italy	22.5%-32.1%	Petrosillo et al[38], 2001
		Lombardi et al[39], 1999
Sudan	23.7%	El-Amin et al[40], 2007
Vietnam	26.6%	Dunford et al[7], 2012
Bosnia and Herzegovina	59.0%	Ahmetagić et al[41], 2006
Peru	59.3%	Sanchez et al[42], 2000
Kuwait	71.0%	Wreghitt[15], 1999
Moldavia	75.0%	Covic et al[43], 1999
Senegal	80.0%	Diouf et al[44], 2000

Table 2 Current recommendations for antiviral treatment of hepatitis C virus infection in maintenance hemodialysis patients with kidney failure[1,54,56,57]

Drug	Dosage	Notes
ST-IFNα-2a	3 million units, three times a week	Usually 48 wk for HCV genotypes 1 and 4, and 24 wk for HCV genotypes 2 and 3, or receiving response-guided treatment A more reduced dose, a longer interval between two injections, or temporary cessation of IFNα should be considered in patients with severe side effects such as dangerous bone marrow suppression
ST-IFNα-2b	3 million units, three times a week
PEG-IFNα-2a	135 μg, once a week
PEG-IFNα-2b	1 μg/kg, once a week
Ribavirin	200 mg, once a day, every other day, or thrice weekly after hemodialysis	Ribavirin is applied in combination with interferon, and should be prohibited if severe anemia or other adverse effects occurs

HCV: Hepatitis C virus; ST-IFNα: Standard interferon alpha; PEG-IFNα: Pegylated interferon alpha.