HCV care strategies in hemodialysis centers in Poland
Background: Chronic hepatitis C (CHC) is prevalent in hemodialysis-dependent population. Currently with the advent of interferon-free antiviral therapies patients with CHC should be considered for treatment, whereas still many hemodialysis-patients are left untreated. Following HCV cure accurate surveillance is mandatory to reduce liver-related mortality and to prevent reinfection. Methods: Polish adult dialysis centers were surveyed anonymously via email between January and December 2022. The HCV management practices across dialysis centers and potential barriers for HCV elimination in hemodialysis setting were investigated. Results: Representatives of 112 dialysis centers responded, representing 42.3% of all dialysis centers in Poland and 43.4% of hemodialysis-dependent patients’ volume. Virtually all surveyed respondents were Heads of hemodialysis centers and board-certified nephrologists. The study demonstrated that in vast majority of hemodialysis centers (91.6%) subjects are considered for antiviral treatment (AVT), however many obstacles preventing patients from being prescribed with AVT were identified; patients’ reluctance to undergo AVT was most reported (60%). Majority of dialysis units neither evaluate patients with CHC for livers fibrosis (60.4%) nor screen them for hepatocellular carcinoma (53.5%). Conclusions: 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 hemodialysis population in Poland.