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Research ArticleBrief Communication
Open Access

Silent reactivation of Varicella Zoster virus in hemodialysis patients.

A management dilemma

Bandar A. Suliman, Hassan T. Alhazmi, Hamzah A. Alamri, Ahmed A. Aljuhani, Mohammed S. Younis, Khalid H. Mahallawi, Fayez H. Alsehli, Ibrahim T. Alomani, Bashayer A. Almoutairi, Yasser S. Asar, Mohammed A. Alkhaily, Walaa A. Momena and Waleed H. Mahallawi
Saudi Medical Journal December 2024, 45 (12) 1391-1395; DOI: https://doi.org/10.15537/smj.2024.45.12.20240553
Bandar A. Suliman
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Hassan T. Alhazmi
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Hamzah A. Alamri
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Ahmed A. Aljuhani
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Mohammed S. Younis
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Khalid H. Mahallawi
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Fayez H. Alsehli
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Ibrahim T. Alomani
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Bashayer A. Almoutairi
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Yasser S. Asar
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Mohammed A. Alkhaily
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Walaa A. Momena
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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Waleed H. Mahallawi
From the Department of Clinical Laboratory Sciences (Suliman, Alhazmi, Alamri, Aljuhani, Younis) and from the Clinical Nutrition Department (Mumena), College of Applied Medical Sciences, Taibah University; from the Health Affairs Department (Mahallawi), Rehabilitation Hospital, Ministry of Health; from the Madinah Regional Blood Bank (Alsehli), from Madinah Regional Laboratory (Alomani, Almoutairi, Asar), from the Madinah Health Cluster (Alkhaily), Ministry of Health, Al Madina Al Munawarah, Kingdom of Saudi Arabia.
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  • ORCID record for Waleed H. Mahallawi
  • For correspondence: [email protected]
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Article Figures & Data

Tables

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    Table 1

    - Hemodialysis patients and healthy controls characteristics.

    VariablesHemodialysis patients (n=174)Healthy controls (n=91)Total (n=265)
    Age group
    18- 30 years8 (4.60)29 (31.9)37 (14.0)
    31- 40 years16 (9.20)27 (29.7)43 (16.2)
    41- 50 years72 (41.4)32 (35.2)104 (39.2)
    >50 years78 (44.8)3 (3.30)81 (30.6)
    Gender
    Male107 (61.5)48 (52.7)155 (58.5)
    Female67 (38.5)43 (47.3)110 (41.5)
    Cause of renal failure§
    Hypertension144 (82.8)-144 (82.8)
    Diabetes mellitus60 (34.5)60 (34.5)
    Hypertension+ Diabetes mellitus41 (23.6)41 (23.6)
    Others†11 (6.32)11 (6.32)

    Numbers presented in table are frequencies (percentages).

    • ↵§ total number of observations is not equal to 174.

    • ↵† Other causes of renal failure include kidney stones, systemic lupus erythematosus, glomerulonephritis, renal hypoplasia.

    • View popup
    Table 2

    - Association between sample characteristics and biomarkers in relation to IgG status among hemodialysis patients (N=174).

    VariablesNon-reactive IgG <1.6 mg/dl (n=14)Reactive IgG ≥ 1.6 mg/dl (n=160)P-value
    Age group, n (%)
    18- 30 years1 (7.14)7 (4.38)0.070
    31- 40 years4 (28.6)12 (7.50)
    41- 50 years4 (28.6)68 (42.5)
    >50 years5 (35.7)73 (45.6)
    Gender, n (%)
    Male9 (64.3)98 (61.3)1.000
    Female5 (35.7)62 (38.8)
    Cause of renal failure, n (%)
    Hypertension, yes10 (71.4)134 (83.8)0.267
    Hypertension, no4 (28.6)26 (16.3)
    Diabetes mellitus, yes2 (14.3)58 (36.3)0.142
    Diabetes mellitus, no12 (85.7)101 (63.1)
    Hypertension+ Diabetes mellitus, yes0 (0.00)41 (25.6)0.042*
    Hypertension+ Diabetes mellitus, no14 (100)119 (74.4)
    Others, yes§2 (14.3)9 (5.63)0.217
    Others, no12 (85.7)151 (94.4)
    Biomarkers
    Albumin, g/dl, mean ± SD3.54 ± 0.293.58 ± 1.210.543
    Median (IQR)3.60 (3.20- 3.80)3.50 (3.30- 3.73)
    Hemoglobin, g/dl, mean ± SD10.7 ± 1.5511.0 ± 1.590.531
    Median (IQR)10.8 (0.05- 11.8)11.0 (10.1- 11.8)
    Random glucose, mg/dl, mean ± SD134 ± 21.0138 ± 27.40.604
    Median (IQR)132 (117- 148)130 (119- 166)
    • ↵§ Other causes of renal failure include kidney stones, systemic lupus erythematosus, glomerulonephritis, renal hypoplasia. Fisher’s exact test and Mann-Whitney test were used to obtain data presented in table. SD: standard deviation, IQR: interquartile range, IG: immunoglobulin

    • View popup
    Table 3

    - Simple linear regression analysis of associations of IgG ratio in hemodialysis patients (N=174).

    VariablesBetaStandard errorP-value95% Confidence IntervalR-square
    Age0.030.030.284-0.02 to 0.080.01
    Gender-0.810.660.224-2.12 to 0.500.01
    Cause of renal failure
    Hypertension0.460.850.593-1.23 to 2.140.00
    Diabetes mellitus0.760.680.262-0.58 to 2.100.01
    Hypertension+ Diabetes mellitus1.340.750.077-0.15 to 2.830.02
    Others0.191.330.887-2.43 to 2.810.00
    Biomarkers
    Albumin, g/dl-0.140.280.618-0.69 to 0.410.00
    Hemoglobin, g/dl-0.130.200.54-0.53 to 0.280.00
    Random glucose, mg/dl0.010.010.490-0.02 to 0.030.00

    SD: standard deviation, IQR: interquartile range, IG: immunoglobulin

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    Silent reactivation of Varicella Zoster virus in hemodialysis patients.
    Bandar A. Suliman, Hassan T. Alhazmi, Hamzah A. Alamri, Ahmed A. Aljuhani, Mohammed S. Younis, Khalid H. Mahallawi, Fayez H. Alsehli, Ibrahim T. Alomani, Bashayer A. Almoutairi, Yasser S. Asar, Mohammed A. Alkhaily, Walaa A. Momena, Waleed H. Mahallawi
    Saudi Medical Journal Dec 2024, 45 (12) 1391-1395; DOI: 10.15537/smj.2024.45.12.20240553

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    Silent reactivation of Varicella Zoster virus in hemodialysis patients.
    Bandar A. Suliman, Hassan T. Alhazmi, Hamzah A. Alamri, Ahmed A. Aljuhani, Mohammed S. Younis, Khalid H. Mahallawi, Fayez H. Alsehli, Ibrahim T. Alomani, Bashayer A. Almoutairi, Yasser S. Asar, Mohammed A. Alkhaily, Walaa A. Momena, Waleed H. Mahallawi
    Saudi Medical Journal Dec 2024, 45 (12) 1391-1395; DOI: 10.15537/smj.2024.45.12.20240553
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    Keywords

    • Varicella-zoster virus
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