Cochrane Reviews are undertaken by teams of volunteer authors, wh

Cochrane Reviews are undertaken by teams of volunteer authors, who have access to free training resources, reference texts and software for preparing and maintaining their review. Here we selleck kinase inhibitor aim to describe the steps involved to undertake a new or

update an existing Cochrane Review. “
“The incidence of hepatitis B virus (HBV) infection in dialysis populations has declined over recent decades, largely because of improvements in infection control and widespread implementation of HBV vaccination. Regardless, outbreaks of infection continue to occur in dialysis units, and prevalence rates remain unacceptably high. For a variety of reasons, dialysis patients are at increased risk of acquiring HBV. They also demonstrate different disease manifestations compared with healthy

individuals and are more likely to progress to chronic carriage. This paper will review the epidemiology, modes of transmission and diagnosis of HBV in this population. Prevention and treatment will be discussed, with a specific focus Tamoxifen cell line on strategies to improve vaccination response, new therapeutic options and selection of patients for therapy. Hepatitis B virus (HBV) infection is a substantial global health problem. It is estimated that more than two billion people worldwide have serological evidence of current or historical infection.1 HBV is highly infectious compared with other blood-borne viruses: An untreated percutaneous exposure to an infected source carries a risk of seroconversion of up to 30%. By contrast,

the risks for hepatitis C virus and human immunodeficiency virus (HIV) are 1.8% and 0.31%, respectively.2 Acute infection occasionally results in fulminant hepatitis, but more importantly can progress to a chronic state, where decompensation, cirrhosis and hepatocellular carcinoma are all potential complications. Compared with the general population, dialysis patients are at increased risk of acquiring HBV. Reasons very include increased exposure to blood products, shared haemodialysis (HD) equipment, breaching of skin and immunodeficiency. Haemodialysis, which requires access to the bloodstream, also affords an opportunity for transmission of HBV between patients, and between patients and staff. Viral hepatitis complicating HD has been recognized from the earliest days of this therapy. While the introduction of vaccination programmes and stringent infection control measures have succeeded in limiting the spread of hepatitis infection within dialysis facilities, outbreaks continue to occur periodically and prevalence rates remain unacceptably high. As such, HBV infection remains an important issue in renal replacement therapy. Hepatitis B is a blood-borne virus. Modes of infection include perinatal, and through percutaneous or mucosal exposure to infected blood or body fluids.3 There are considered to be more than 350 million people worldwide with chronic hepatitis B infection.

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