Change in hepatitis C virus genotype in hemodialysis patients after end-of-treatment response to interferon monotherapy-relapse or re-infection?

Hepatitis C virus (HCV) infection remains common among hemodialysis patients and its occurrence is related mainly to nosocomial spread. Although dialysis patients with HCV infection respond well to interferon-based therapy, relapse is frequent. This study aimed at a selected group of hemodialysis pa...

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Detalhes bibliográficos
Autores: Arrais, Teresa Cristina de Oliveira Maia [UNIFESP], Van Dooren, Sonia, Vandamme, Anne-Mieke, Brechot, Christian, Rimlinger, Francois, Silva, Antonio Eduardo Benedito [UNIFESP], Perez, Renata de Mello [UNIFESP], Ferraz, Maria Lucia Cardoso Gomes [UNIFESP], Thiers, Valerie
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2008
País:Brasil
Recursos:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/30223
Acesso em linha:http://dx.doi.org/10.1002/jmv.21050
http://repositorio.unifesp.br/handle/11600/30223
Access Level:acceso abierto
Palavra-chave:HCV
hemodialysis
nosocomial transmission
genotype
NS5B region
Descrição
Resumo:Hepatitis C virus (HCV) infection remains common among hemodialysis patients and its occurrence is related mainly to nosocomial spread. Although dialysis patients with HCV infection respond well to interferon-based therapy, relapse is frequent. This study aimed at a selected group of hemodialysis patients infected with HCV infection undergoing interferon therapy who achieved end-of-treatment virological response but became HCV-RNA positive again 6 months after end-of-treatment. It was evaluated whether de novo HCV-RNA positivity in these non-sustained responders occurred due to lack of clearance of HCV after the initial response to interferon-alpha (relapse) or due to re-infection with a new strain (re-infection). Genotyping by Inno-LiPA and by phylogenetic tree analysis using partial HCV-NS5B sequences at two evaluation points: pre-treatment (TO) and 6 months after end-of-treatment (T0). Non-sustained responders (n = 15) carried subtypes la (8 patients), 1b (4 patients), 3a (2 patients), and 4a (11 patient) before treatment. Identical subtypes were detected in 10 patients at T18. Five patients changed genotypes at T18, suggesting nosocomial re-infection. This study emphasizes the importance of epidemiologic measures to control the re-exposure of hemodialysis patients treated previously for HCV infection.

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