Hepatitis C virus antigen detection is an appropriate test for screening and early diagnosis of hepatitis C virus infection in at-risk populations and immunocompromised hosts.

Early diagnosis remains key for effective prevention and treatment. Unfortunately, current screening with anti-hepatitis C virus antibody (anti-HCV Ab) test may have limited utility in the diagnosis of HCV infection and reinfection. This is of special concern to at-risk population, such as immunocompromised hosts and end-stage renal failure patients on hemodialysis. HCV antigen (Ag) could be useful in identifying the ongoing infection in such clinical scenarios. Hence, we aimed to study the utility of HCV Ag testing for the diagnosis of acute and chronic hepatitis C. Of 89 samples studied, 19 were from acute hepatitis C patients who were immunocompromised or were on hemodialysis, 43 were from active chronic hepatitis C patients and 27 were from patients treated for chronic hepatitis C. All samples were tested for HCV Ag using the Abbott ARCHITECT HCV Ag assay. HCV Ag was reactive in 19/19 samples from acute hepatitis C patients and 42/43 samples from active chronic hepatitis C patients. It was nonreactive in all samples from treated patients. The test showed a sensitivity and specificity of 98.4% and 100.0%, respectively. The positive and negative predictive values were 100.0% and 96.4%, respectively. The HCV antigen test has high clinical sensitivity and specificity and is useful for the diagnosis of acute and chronic hepatitis C infection in at-risk and immunocompromised patients. Its short turnaround time and relatively low cost are advantageous for use in patients on hemodialysis and other at-risk patients who require monitoring of HCV infection and reinfection.

COVID-19 vaccination in peritoneal dialysis patients.

BACKGROUND: COVID-19 vaccine is recommended in Peritoneal dialysis (PD) patients, but a paucity of data is available regarding vaccine-related adverse effects among PD patients. METHOD: A cross-sectional study was conducted in a single center between October and November 2021. PD patients were provided with the online survey link to participate in the study. RESULTS: A total of 107 PD patients responded to the survey (55%: male, 79%: Chinese, 40%: > 65 years old). Of these, 95% received the COVID-19 vaccine (77% received two doses and 22% received three doses). Most participants (91%) received Pfizer vaccine. The main source of vaccine information was from the government (48%). The most common reason to receive and refuse vaccines were the perception of the seriousness of COVID-19 infection (63%) and concern about vaccine safety (60%), respectively. After the first dose, 25% of patients developed one or more vaccine-related adverse effects. Common local adverse effect was pain at the injection site (21%), and systemic adverse effects were muscle pain (15%), fatigue (13%). Similar adverse effects were observed with subsequent doses. None of them required hospitalization for vaccine-related adverse effects. Female patients had a higher risk of developing adverse effects than male patients after the first dose (odds ratio: 3.37; 95% confidence interval: 1.25 - 9.08). No such difference was observed in the subsequent dose. Age, race, employment status and history of drug allergy were not associated with the risk of adverse effects. CONCLUSIONS: The COVID-19 vaccine was well-tolerated by most PD patients, but few experienced non-severe adverse effects. All PD patients should be vaccinated against SAR-COV-2 infection.