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  3. 25. One Year Mortality & Reinfection Rate of Hepatitis C Among Patients on Hemodialysis after Successful Direct-Acting Antiviral Treatment
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25. One Year Mortality & Reinfection Rate of Hepatitis C Among Patients on Hemodialysis after Successful Direct-Acting Antiviral Treatment

Sidra Shafiq Cheema1, Ambreen Tauseef1, Manal Fatima1, Marium Danish Iqbal1, Sana Khurshid2 and Shafiq ur Rehman Cheema2

ABSTRACT

Objective: The key goal of this research is to evaluate the incidence of HCV reinfection among patients undergoing maintenance hemodialysis (MHD) after achieving successful treatment for hepatitis C.

Study Design: A prospective randomized interventional trial study

Place and Duration of Study: This study was conducted at the Jinnah Hospital dialysis center from January 2021 till December 2022.

Materials and Methods: We led a prospective randomized interventional trial at Jinnah Hospital dialysis center, analyzing data from a group of patients undergoing MHD who had previously received direct acting antivirals (DAA) therapy for HCV treatment. Following successful therapy with DAA and accomplishment of sustained virologic response (SVR), these patients were monitored for one year. During this period, strict adherence to "universal precautions" was implemented to prevent cross-contamination of HCV. HCV RNA PCR measurements were taken at the one-year mark to assess reinfection, defined as a positive HCV RNA measurement after SVR. In cases where reinfection was detected, genotyping was performed. We calculated the raw rates of reinfection per 100 person-years as a measure of reinfection incidence. Additionally, as a secondary objective, we calculated the one-year mortality rate within this treated population.

Results: Among the cohort of patients treated with DAAs, none of the patients in group 1 experienced reinfection one year after achieving SVR. However, in group 2, two out of 14 patients were identified with reinfection, and the genotype of the reinfection matched their previous genotype. The overall reinfection rate in the entire cohort was 2 out of 32 patients, amounting to 6.25%. The crude reinfection rate was calculated to be 6.25 per 100 person-years. Furthermore, the one-year mortality rate was determined to be 16% in group 1 and 44% in group 2.

Conclusion: The rate of reinfection among patients on maintenance hemodialysis who have been successfully treated for HCV is low when strict implementation and compliance to "universal precautions" are practiced.

Key Words: Mortality & Reinfection Rate, Hepatitis C, Hemodialysis, Direct-acting antiviral Treatment.

Citation of article: Cheema SS, Tauseef A, Fatima M, Iqbal MD, Khurshid S, Cheema SR. One Year Mortality & Reinfection Rate of Hepatitis C Among Patients on Hemodialysis after Successful Direct-Acting Antiviral Treatment. Med Forum 2023;34(7):107-111. doi:10.60110/medforum.340725.