Czarnecka Paulina, Czarnecka Kinga, Tronina Olga, Baczkowska Teresa, Zarychta-Wisniewska Weronika, Durlik Magdalena
Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland.
Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland.
J Clin Med. 2023 Apr 4;12(7):2711. doi: 10.3390/jcm12072711.
Chronic hepatitis C (CHC) is prevalent in the hemodialysis-dependent population. Currently, all patients with CHC should be considered for treatment; however, many hemodialysis-dependent patients are still left untreated. Following HCV cure, accurate surveillance is mandatory to reduce liver-related mortality and prevent reinfection. We aimed to establish HCV management practices and barriers to HCV elimination in dialysis centers in Poland. Polish dialysis centers were surveyed via email. The HCV management strategies were investigated. Representatives of 112 dialysis centers responded, representing 43.1% of all dialysis centers in Poland and 43.4% of hemodialysis-dependent patients' volume. Most respondents were Heads of hemodialysis centers and board-certified nephrologists. The study demonstrated that in the vast majority of hemodialysis centers (91.6%), subjects are considered for antiviral treatment (AVT); however, many obstacles preventing patients from being prescribed AVT were identified; patients' reluctance to undergo AVT was most reported (60%). The majority of dialysis units neither evaluate patients with CHC for liver fibrosis (60.4%) nor screen them for hepatocellular carcinoma (53.5%). In conclusion, the presented study demonstrates that HCV management practices across Polish dialysis centers vary substantially. There is a need to optimize and streamline the HCV management infrastructure in the hemodialysis population in Poland.
慢性丙型肝炎(CHC)在依赖血液透析的人群中普遍存在。目前,所有CHC患者均应考虑接受治疗;然而,许多依赖血液透析的患者仍未得到治疗。丙肝治愈后,必须进行准确的监测,以降低肝脏相关死亡率并防止再次感染。我们旨在确定波兰透析中心的丙肝管理实践及消除丙肝的障碍。通过电子邮件对波兰透析中心进行了调查。对丙肝管理策略进行了研究。112个透析中心的代表做出了回应,占波兰所有透析中心的43.1%,以及依赖血液透析患者总量的43.4%。大多数受访者是血液透析中心主任和获得委员会认证的肾病专家。研究表明,在绝大多数血液透析中心(91.6%),患者会被考虑接受抗病毒治疗(AVT);然而,也发现了许多阻碍患者接受AVT治疗的障碍;最常被报告的是患者不愿接受AVT治疗(60%)。大多数透析单位既不评估CHC患者的肝纤维化情况(60.4%),也不对其进行肝细胞癌筛查(53.5%)。总之,本研究表明波兰各透析中心的丙肝管理实践差异很大。有必要优化和简化波兰血液透析人群的丙肝管理基础设施。