Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21)

Frontiers in Medicine

article

Zhaohui Ni¹  Xiaonong Chen²  Yuqing Chen³  Li Zuo⁴  Liangying Gan⁴  Dongyu Wang⁵  Brian Bieber⁵  Keith McCullough⁵  Michel Jadoul⁶  Ronald L. Pisoni⁵  Fanfan Hou⁷  Xinling Liang⁸ 

[1] Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine;Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Renal Division, Peking University First Hospital;Department of Nephrology, Peking University People's Hospital;Arbor Research Collaborative for Health;Cliniques Universitaires Saint-Luc, Université Catholique de Louvain;State Key Laboratory of Organ Failure Research, Division of Nephrology, National Clinical Research Center of Kidney Disease, Nanfang Hospital, Southern Medical University;Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences

关键词: chronic kidney disease;    hemodialysis;    hepatitis C virus;    prevalence;    incidence;    Dialysis Outcomes and Practice Patterns Study;   

DOI  :  10.3389/fmed.2022.910840

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Prior work from the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed HCV prevalence in China in 2012–2015 being in the upper third and HCV incidence the 2nd highest among 15 different countries/regions investigated. The goal of the present investigation was to: (1) determine if HCV prevalence and incidence has changed, and (2) collect detailed data to understand how HCV is treated, monitored, and managed in Chinese HD facilities and non-dialysis chronic kidney disease (CKD) clinics. Data and Methods Detailed data for 1,700 randomly selected HD patients were reported by 39 randomly selected HD facilities from Beijing, Shanghai, and Guangzhou participating in the DOPPS 7-China study from 2019 to 2021. The study site medical directors completed a survey regarding numerous aspects of HCV treatment and management in HD and ND-CKD patients. Results In this 2019 to 2021 cohort, HCV prevalence was 7.4%, which was lower than the 14.8 and 11.5% HCV prevalence for the 2009–2011 and 2012–2015 cohorts, respectively. HCV incidence of 1.2 cases per 100 pt-yrs also was lower compared to the incidence of 2.1 for the 2012–2015 cohort. Although the great majority of study site medical directors indicated that all or nearly HCV+ patients should be treated for their HCV, very few HCV+ patients have been treated presumably due to substantial cost barriers for affording the new direct acting antivirals (DAAs). The randomly selected facilities in our DOPPS 7-China study appear to have excellent programs in place for frequent monitoring of patients and staff for HCV, education of staff, and referral of HCV cases to external infectious disease, gastroenterology, and liver disease specialists. Liver biopsies were not commonly performed in HCV+ HD patients. HCV genotyping also was rarely performed in participating units. Conclusions Our study indicates a 50% decline in HCV prevalence and a >40% decline in HCV incidence in Chinese HD patients over the past 10–12 yrs. Chinese HD facilities and associated specialists appear to be well-equipped and organized for successfully treating and managing their HCV+ HD and CKD patients in order to achieve the WHO goal of eliminating HCV by 2030.

【 授权许可】

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