Factors associated with the progression of hepatic fibrosis in end-stage kidney disease patients with hepatitis C virus infection

Factors associated with the progression of hepatic fibrosis in end-stage kidney disease patients with hepatitis C virus infection

Author Becker, Vitoria R. Autor UNIFESP Google Scholar
Badiani, Rosilene das Graças Autor UNIFESP Google Scholar
Lemos, Lara B. Autor UNIFESP Google Scholar
Perez, Renata M. Google Scholar
Medina-Pestana, Jose O. Autor UNIFESP Google Scholar
Lanzoni, Valeria P. Autor UNIFESP Google Scholar
Ferreira, Adalgisa R. Google Scholar
Silva, Antonio Eduardo B. Autor UNIFESP Google Scholar
Ferraz, Maria Lucia G. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Univ Fed Maranhao
Universidade Federal do Rio de Janeiro (UFRJ)
Abstract Background Few studies have evaluated the histological aspects of hepatitis C virus (HCV) infection in hemodialysis patients and the factors related to the progression of hepatic fibrosis in this population have not been defined.Aim To evaluate the influence of host-related factors on the fibrosis progression in end-stage renal disease (ESRD) patients with HCV infection.Methods HCV-infected ESRD patients who submitted to liver biopsy were included. the fibrosis stages were classified according to METAVIR scoring system. for the identification of factors associated with more advanced liver fibrosis, the patients were classified into two groups: group 1, absence of septal fibrosis (F0-1) and group 2, presence of septal fibrosis (F2-4). Groups 1 and 2 were compared regarding demographic, epidemiological, and laboratory variables and logistic regression analysis was used to identify the variables that were independently associated with the presence of septal fibrosis.Results A total of 216 ESRD patients (63% men, 44 +/- 11 years) were included. in the histological analysis, the fibrosis stages were as follows: F0=36%, F1 =41%, F2 = 12%, F3 = 7, and 4% had cirrhosis (F4). in the logistic regression model, the variables that were independently associated with the presence of septal fibrosis were duration of infection, estimated age at infection, coinfection with HBV and aspartate aminotransferase levels.Conclusion These findings support the importance of obtaining an adequate immune response to HBV vaccination and careful monitoring of liver disease in patients who become infected at an advanced age and/or those presenting elevated aspartate aminotransferase levels, as these are the main factors associated with the presence of septal fibrosis in ESRD patients. Eur J Gastroenterol Hepatol 21:1395-1399 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Keywords end-stage kidney disease
hepatic fibrosis
hepatitis C
Language English
Date 2009-12-01
Published in European Journal of Gastroenterology & Hepatology. Philadelphia: Lippincott Williams & Wilkins, v. 21, n. 12, p. 1395-1399, 2009.
ISSN 0954-691X (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 1395-1399
Origin http://dx.doi.org/10.1097/MEG.0b013e328313bbc1
Access rights Closed access
Type Article
Web of Science ID WOS:000272115800012
URI http://repositorio.unifesp.br/handle/11600/32003

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