Abstract
Background:The major complication of tunneled vascular catheters in dialysis patients is infection. In preliminary work, an association was noted between hepatitis C virus (HCV) infection and bacteremia in these patients. On this basis, we theorized that HCV infection may be associated with bacteremia in dialysis patients with tunneled catheters.Methods:We conducted a two-phase clinical study to define the association between HCV infection and bacteremia in hemodialysis patients with catheters. Phase 1 was a cross-sectional study designed to assess the association between HCV serologic status and bacteremia. Phase 2 was a prospective study that examined the relationship between HCV viral load and bacteremia.Results:In Phase 1, HCV (+) patients had a significantly greater prevalence of bacteremia than HCV (−) patients (61 vs 7.7% respectively, P < 0.05). In Phase 2, the presence of detectable virus was associated with a numerical trend toward an increase in the incidence of bacteremia (40 vs 0% for patients with and without detectable virus, respectively, P = 0.09).Conclusion:These studies suggest that HCV infection may be associated with the development of bacteremia in hemodialysis patients with tunneled catheters.
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References
References1. NKF-K/DOQI. Clinical Practice Guidelines for Vascular Access: Update 2006. III. Prevention of Complications: Infection. National Kidney Foundation, 2006.NKF-K/DOQIClinical Practice Guidelines for Vascular Access: Update 2006. III. Prevention of Complications: Infection.National Kidney Foundation20062. Quarello F, Forneris G, Borca M, et al. Do central venous catheters have advantages over arteriovenous fistulas or grafts? J Nephrol 2006;19:265–279.QuarelloF]]FornerisG]]BorcaM&etal;Do central venous catheters have advantages over arteriovenous fistulas or grafts?J Nephrol200619265-2793. Sullivan R, Samuel V, Le C, et al. Hemodialysis catheter-related bacteremia. Am J Med Sci 2007;334:458–465.SullivanR]]SamuelV]]LeC&etal;Hemodialysis catheter-related bacteremia.Am J Med Sci2007334458-4654. Alexandraki I, Sullivan R, Zaiden R, et al. Blood culture isolates in hemodialysis vascular catheter-related bacteremia. Amer J Med Sci 2008;336:297–302.AlexandrakiI]]SullivanR]]ZaidenR&etal;Blood culture isolates in hemodialysis vascular catheter-related bacteremia.Amer J Med Sci2008336297-3025. Zaiden R, Sullivan R, Reddy S, et al. Cross-sectional study of the relationship between hepatitis C and bacteremia in hemodialysis patients with vascular catheters. J Am Soc Nephrol 2006;17:589A.ZaidenR]]SullivanR]]ReddyS&etal;Cross-sectional study of the relationship between hepatitis C and bacteremia in hemodialysis patients with vascular catheters.J Am Soc Nephrol200617589A6. Reddy S, Zaiden R, Sullivan R, et al. Hepatitis C viral load and the risk of bacteremia in hemodialysis patients with vascular catheters. J Invest Med 2007;55:S308.ReddyS]]ZaidenR]]SullivanR&etal;Hepatitis C viral load and the risk of bacteremia in hemodialysis patients with vascular catheters.J Invest Med200755S3087. Germer JJ, Harmsen WS, Mandrekar JN, et al. Evaluation of the COBAS TaqMan HCV test with automated sample processing using the MagNA pure LC instrument. J Clin Microbiol 2005;43:293–298.GermerJJ]]HarmsenWS]]MandrekarJN&etal;Evaluation of the COBAS TaqMan HCV test with automated sample processing using the MagNA pure LC instrument.J Clin Microbiol200543293-2988. Saad TF. Central venous dialysis catheters: catheter-associated infection. Semin Dial 2001;14:446–451.SaadTFCentral venous dialysis catheters: catheter-associated infection.Semin Dial200114446-4519. Lopez de Mendoza V, Reddy S, Sullivan R, et al. Natural history of vascular access catheters in hemodialysis patients. J Invest Med 2007;55:S272.Lopez de MendozaV]]ReddyS]]SullivanR&etal;Natural history of vascular access catheters in hemodialysis patients.J Invest Med200755S27210. Ono Y, Watanabe T, Matsumoto K, et al. Opsonophagocytic dysfunction in patients with liver cirrhosis and low responses to tumor necrosis factor-alpha and lipopolysaccharide in patients’ blood. J Infect Chemother 2004;10:200–207.OnoY]]WatanabeT]]MatsumotoK&etal;Opsonophagocytic dysfunction in patients with liver cirrhosis and low responses to tumor necrosis factor-alpha and lipopolysaccharide in patients’ blood.J Infect Chemother200410200-20711. Jirillo E, Greco B, Caradonna L, et al. Evaluation of cellular immune responses and soluble mediators in patients with chronic hepatitis C virus (cHCV) infection. Immunopharmacol Immunotoxicol 1995;17:347–364.JirilloE]]GrecoB]]CaradonnaL&etal;Evaluation of cellular immune responses and soluble mediators in patients with chronic hepatitis C virus (cHCV) infection.Immunopharmacol Immunotoxicol199517347-36412. Pavio N, Lai MM. The hepatitis C virus persistence: how to evade the immune system? J Biosci 2003;28:287–304.PavioN]]LaiMMThe hepatitis C virus persistence: how to evade the immune system?J Biosci200328287-30413. Anderson KB, Guest JL, Rimland D. Hepatitis C virus coinfection increases mortality in HIV-infected patients in the highly active antiretroviral therapy era: data from the HIV Atlanta VA Cohort Study. Clin Infect Dis 2004;39:1507–1513.AndersonKB]]GuestJL]]RimlandDHepatitis C virus coinfection increases mortality in HIV-infected patients in the highly active antiretroviral therapy era: data from the HIV Atlanta VA Cohort Study.Clin Infect Dis2004391507-151314. Miller MF, Haley C, Koziel MJ, et al. Impact of hepatitis C virus on immune restoration in HIV-infected patients who start highly active antiretroviral therapy: a meta-analysis. Clin Infect Dis 2005;41:713–720.MillerMF]]HaleyC]]KozielMJ&etal;Impact of hepatitis C virus on immune restoration in HIV-infected patients who start highly active antiretroviral therapy: a meta-analysis.Clin Infect Dis200541713-72015. Allon M. Dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis 2004;44:779–791.AllonMDialysis catheter-related bacteremia: treatment and prophylaxis.Am J Kidney Dis200444779-791
