Displaying publications 1 - 20 of 198 in total

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  1. Ahmad L, Hung TL, Mat Akhir NA, Mohamed R, Nathan S, Firdaus-Raih M
    BMC Microbiol, 2015;15:270.
    PMID: 26597807 DOI: 10.1186/s12866-015-0604-4
    There are still numerous protein subfamilies within families and superfamilies that do not yet have conclusive empirical experimental evidence providing a specific function. These proteins persist in databases with the annotation of a specific 'putative' function made by association with discernible features in the protein sequence.
  2. Ahmad MK, Tabana YM, Ahmed MA, Sandai DA, Mohamed R, Ismail IS, et al.
    Malays J Med Sci, 2017 Dec;24(6):29-38.
    PMID: 29379384 DOI: 10.21315/mjms2017.24.6.4
    Background: A norovirus maintains its viability, infectivity and virulence by its ability to replicate. However, the biological mechanisms of the process remain to be explored. In this work, the NanoLuc™ Luciferase gene was used to develop a reporter-tagged replicon system to study norovirus replication.

    Methods: The NanoLuc™ Luciferase reporter protein was engineered to be expressed as a fusion protein for MNV-1 minor capsid protein, VP2. The foot-and-mouth disease virus 2A (FMDV2A) sequence was inserted between the 3'end of the reporter gene and the VP2 start sequence to allow co-translational 'cleavage' of fusion proteins during intracellular transcript expression. Amplification of the fusion gene was performed using a series of standard and overlapping polymerase chain reactions. The resulting amplicon was then cloned into three readily available backbones of MNV-1 cDNA clones.

    Results: Restriction enzyme analysis indicated that the NanoLucTM Luciferase gene was successfully inserted into the parental MNV-1 cDNA clone. The insertion was further confirmed by using DNA sequencing.

    Conclusion: NanoLuc™ Luciferase-tagged MNV-1 cDNA clones were successfully engineered. Such clones can be exploited to develop robust experimental assays for in vitro assessments of viral RNA replication.

  3. Ahmad N, Zakaria WR, Mohamed R
    Helicobacter, 2011 Feb;16(1):47-51.
    PMID: 21241412 DOI: 10.1111/j.1523-5378.2010.00816.x
    The prevalence of antibiotic resistance varies in geographic areas. The information on the antibiotic susceptibility patterns of Helicobacter pylori (H. pylori) in our local setting is therefore relevant as a guide for the treatment options.
  4. Ahmad N, Zakaria WR, Abdullah SA, Mohamed R
    World J Gastroenterol, 2009 Jul 07;15(25):3161-5.
    PMID: 19575497
    AIM: To characterize the types of mutations present in the 23S rRNA genes of Malaysian isolates of clarithromycin-resistant Helicobacter pylori (H pylori).

    METHODS: Clarithromycin susceptibility of H pylori isolates was determined by E test. Analyses for point mutations in the domain V of 23S rRNA genes in clarithromycin-resistant and -sensitive strains were performed by sequence analysis of amplified polymerase chain reaction products. Restriction fragment length polymorphism was performed using BsaI and MboII enzymes to detect restriction sites that correspond to the mutations in the clarithromycin-resistant strains.

    RESULTS: Of 187 isolates from 120 patients, four were resistant to clarithromycin, while 183 were sensitive. The MIC of the resistant strains ranged from 1.5 to 24 microg/mL. Two isolates had an A2142G mutation and another two had A2143G mutations. A T2182C mutation was detected in two out of four clarithromycin-resistant isolates and in 13 of 14 clarithromycin-sensitive isolates. Restriction enzyme analyses with BsaI and MboII were able to detect the mutations.

    CONCLUSION: Clarithromycin resistance is an uncommon occurrence among Malaysian isolates of H pylori strains and the mutations A2142G and A2143G detected were associated with low-level resistance.

  5. Al-Fasih MY, Mohamad ME, Ibrahim IS, Ahmad Y, Ariffin MAM, Sarbini NN, et al.
    PLoS One, 2021;16(5):e0252050.
    PMID: 34015027 DOI: 10.1371/journal.pone.0252050
    Effects of different surface textures on the interface shear strength, interface slip, and failure modes of the concrete-to-concrete bond are examined through finite element numerical model and experimental methods in the presence of the horizontal load with 'push-off' technique under different normal stresses. Three different surface textures are considered; smooth, indented, and transversely roughened to finish the top surfaces of the concrete bases. In the three-dimensional modeling via the ABAQUS solver, the Cohesive Zone Model (CZM) is used to simulate the interface shear failure. It is observed that the interface shear strength increases with the applied normal stress. The transversely roughened surface achieves the highest interface shear strength compared with those finished with the indented and smooth approaches. The smooth and indented surfaces are controlled by the adhesive failure mode while the transversely roughened surface is dominated by the cohesive failure mode. Also, it is observed that the CZM approach can accurately model the interface shear failure with 3-29% differences between the modeled and the experimental test findings.
  6. Al-Gheethi A, Noman E, Jeremiah David B, Mohamed R, Abdullah AH, Nagapan S, et al.
    J Water Health, 2018 Oct;16(5):667-680.
    PMID: 30285950 DOI: 10.2166/wh.2018.113
    The menace of cholera epidemic occurrence in Yemen was reported in early 2017. Recent reports revealed that an estimated 500,000 people are infected with cholera whereas 2,000 deaths have been reported in Yemen. Cholera is transmitted through contaminated water and food. Yemen is the least developed country among the Middle East countries in terms of wastewater and solid waste management. The population of Yemen is about 24.5 million and generates about 70-100 million m3 of sewage. An estimated 7% of the population has sewerage systems. It has been revealed that 31.2 million m3 of untreated sewage is used for irrigation purposes especially for vegetables and Khat trees. In addition, more than 70% of the population in Yemen has no potable water. They depend on water wells as a water source which are located close to sewage disposal sites. The present review focuses on the current status of water, wastewater as well as solid waste management in Yemen and their roles in the outbreak of cholera. Future prospects for waste management have been proposed.
  7. Al-Gheethi AA, Radin Mohamed RM, Efaq AN, Amir Hashim MK
    J Water Health, 2016 Jun;14(3):379-98.
    PMID: 27280605 DOI: 10.2166/wh.2015.220
    Greywater is one of the most important alternative sources for irrigation in arid and semi-arid countries. However, the health risk associated with the microbial contents of these waters limits their utilization. Many techniques have been developed and used to generate a high microbiological quality of greywater. The main problem in the treatment of greywater lies in the nature of pathogenic bacteria in terms of their ability to survive during/after the treatment process. The present review focused on the health risk associated with the presence of pathogenic bacteria in greywater and the treatment technologies used for the disinfection processes.
  8. Al-Gheethi AA, Mohamed RM, Efaq AN, Norli I, Abd Halid A, Amir HK, et al.
    J Water Health, 2016 Oct;14(5):780-795.
    PMID: 27740544
    The study probed into reducing faecal indicators and pathogenic bacteria, heavy metals and β-lactam antibiotics, from four types of secondary effluents by bioaugmentation process, which was conducted with Bacillus subtilis strain at 45 °C. As a result, faecal indicators and pathogenic bacteria were reduced due to the effect of thermal treatment process (45 °C), while the removal of heavy metals and β-lactam antibiotics was performed through the functions of bioaccumulation and biodegradation processes of B. subtilis. Faecal coliform met the guidelines outlined by WHO and US EPA standards after 4 and 16 days, respectively. Salmonella spp. and Staphylococcus aureus were reduced to below the detection limits without renewed growth in the final effluents determined by using a culture-based method. Furthermore, 13.5% and 56.1% of cephalexin had been removed, respectively, from secondary effluents containing 1 g of cephalexin L(-1) (secondary effluent 3), as well as 1 g of cephalexin L(-1) and 10 mg of Ni(2+) L(-1) (secondary effluent 4) after 16 days. The treatment process, eventually, successfully removed 96.6% and 66.3% of Ni(2+) ions from the secondary effluents containing 10 mg of Ni(2+) L(-1) (secondary effluent 2) and E4, respectively. The bioaugmentation process improved the quality of secondary effluents.
  9. Al-Gheethi AA, Mohamed RM, Jais NM, Efaq AN, Abd Halid A, Wurochekke AA, et al.
    J Water Health, 2017 Oct;15(5):741-756.
    PMID: 29040077 DOI: 10.2166/wh.2017.080
    The present study aims to investigate the influence of Staphylococcus aureus, Escherichia coli and Enterococcus faecalis in public market wastewater on the removal of nutrients in terms of ammonium (NH4-) and orthophosphate (PO43) using Scenedesmus sp. The removal rates of NH4- and orthophosphate PO43- and batch kinetic coefficient of Scenedesmus sp. were investigated. The phycoremediation process was carried out at ambient temperature for 6 days. The results revealed that the pathogenic bacteria exhibited survival potential in the presence of microalgae but they were reduced by 3-4 log at the end of the treatment process. The specific removal rates of NH4- and PO43- have a strong relationship with initial concentration in the public market wastewater (R2 = 0.86 and 0.80, respectively). The kinetic coefficient of NH4- removal by Scenedesmus sp. was determined as k = 4.28 mg NH4- 1 log10 cell mL-1 d-1 and km = 52.01 mg L-1 (R2 = 0.94) while the coefficient of PO43- removal was noted as k = 1.09 mg NH4- 1 log10 cell mL-1 d-1 and km = 85.56 mg L-1 (R2 = 0.92). It can be concluded that Scenedesmus sp. has high competition from indigenous bacteria in the public market wastewater to remove nutrients, with a higher coefficient of removal of NH4- than PO43.
  10. Al-Qaim FF, Abdullah MP, Othman MR, Latip J, Zakaria Z
    J Chromatogr A, 2014 Jun 6;1345:139-53.
    PMID: 24768127 DOI: 10.1016/j.chroma.2014.04.025
    An analytical method that facilitated the analysis of 11 pharmaceuticals residue (caffeine, prazosin, enalapril, carbamazepine, nifedipine, levonorgestrel, simvastatin, hydrochlorothiazide, gliclazide, diclofenac-Na, and mefenamic acid) with a single pre-treatment protocol was developed. The proposed method included an isolation and concentration procedure using solid phase extraction (Oasis HLB), a separation step using high-performance liquid chromatography, and a detection procedure that applies time-of-flight mass spectrometry. The method was validated for drinking water (DW), surface water (SW), sewage treatment plant (STP) influent and effluent, and hospital (HSP) influent and effluent. The limits of quantification were as low as 0.4, 1.6, 5, 3, 2.2 and 11 ng/L in DW, SW, HSP influent and effluent, STP effluent, and STP influent, respectively. On average, good recoveries higher than 75% were obtained for most of the target analytes in all matrices. Matrix effect was evaluated for all samples matrices. The proposed method successfully determined and quantified the target compounds in raw and treated wastewater of four STPs and three hospitals in Malaysia, as well as in two SW sites. The results showed that a number of the studied compounds pose moderate to high persistency in sewage treatment effluents as well as in the recipient rivers, namely; caffeine, simvastatin, and hydrochlorothiazide. Ten out of 11 compounds were detected and quantified in 13 sampling points. Caffeine was detected with the highest level, with concentrations reaching up to 9099 ng/L in STP influent.
  11. Al-Qaim FF, Mussa ZH, Othman MR, Abdullah MP
    J Hazard Mater, 2015 Dec 30;300:387-397.
    PMID: 26218306 DOI: 10.1016/j.jhazmat.2015.07.007
    The electrochemical oxidation of caffeine, a widely over-the-counter stimulant drug, has been investigated in effluent wastewater and deionized water (DIW) using graphite-poly vinyl chloride (PVC) composite electrode as anode. Effects of initial concentration of caffeine, chloride ion (Cl(-)) loading, presence of hydrogen peroxide (H2O2), sample volume, type of sample and applied voltage were determined to test and to validate a kinetic model for the oxidation of caffeine by the electrochemical oxidation process. The results revealed that the electrochemical oxidation rates of caffeine followed pseudo first-order kinetics, with rate constant values ranged from 0.006 to 0.23 min(-1) depending on the operating parameters. The removal efficiency of caffeine increases with applied voltage very significantly, suggesting a very important role of mediated oxidation process. However, the consumption energy was considered during electrochemical oxidation process. In chloride media, removal of caffeine is faster and more efficiently, although occurrence of more intermediates takes place. The study found that the adding H2O2 to the NaCl solution will inhibit slightly the electrochemical oxidation rate in comparison with only NaCl in solution. Liquid chromatography-time of flight-mass spectrometry (LC-TOF-MS) technique was applied to the identification of the by-products generated during electrochemical oxidation, which allowed to construct the proposed structure of by-products.
  12. Alam S, Eslam M, Skm Hasan N, Anam K, Chowdhury MAB, Khan MAS, et al.
    JGH Open, 2021 Nov;5(11):1236-1249.
    PMID: 34816009 DOI: 10.1002/jgh3.12658
    The pathophysiology and risk factors of nonalcoholic fatty liver disease (NAFLD) among lean patients is poorly understood and therefore investigated. We performed a meta-analysis of observational studies. Of 1175 articles found through searching from Medline/PubMed, Banglajol, and Google Scholar by two independent investigators, 22 were selected. Data from lean (n = 6768) and obese (n = 9253) patients with NAFLD were analyzed; lean (n = 43 398) and obese (n = 9619) subjects without NAFLD served as controls. Age, body mass index, waist circumference, systolic blood pressure, and diastolic blood pressure (DBP) had significantly higher estimates in lean NAFLD patients than in lean non-NAFLD controls. Fasting blood sugar [MD(mean difference) 5.17 mg/dl, 95% CI(confidence interval) 4.14-6.16], HbA1c [MD 0.29%, 95% CI 0.11-0.48], and insulin resistance [HOMA-IR] [MD 0.49 U, 95% CI 0.29-0.68]) were higher in lean NAFLD patients than in lean non-NAFLD controls. All components of the lipid profile were raised significantly in the former group except high-density lipoprotein. An increased uric acid (UA) level was found to be associated with the presence of NAFLD among lean. Cardio-metabolic profiles of nonlean NAFLD patients significantly differs from the counter group. However, the magnitude of the difference of lipid and glycemic profile barely reached statistical significance when subjects were grouped according to lean and nonlean NAFLD. But DBP (slope: 0.19, P 
  13. Alfizah H, Ramelah M, Rizal AM, Anwar AS, Isa MR
    Helicobacter, 2012 Oct;17(5):340-9.
    PMID: 22967117 DOI: 10.1111/j.1523-5378.2012.00956.x
    Polymorphisms of Helicobacter pylori cagA and vacA genes do exist and may contribute to differences in H. pylori infection and gastroduodenal diseases among races in the Malaysian population. This study was conducted to characterize the polymorphisms in H. pylori cagA and vacA in Malaysian population.
  14. Alsalahi A, Alshawsh MA, Mohamed R, Alyousefi NA, Alshagga MA, Shwter AN, et al.
    J Ethnopharmacol, 2016 Jun 20;186:30-43.
    PMID: 27025406 DOI: 10.1016/j.jep.2016.03.045
    ETHNOPHARMACOLOGICAL RELEVANCE: Traditionally, the leaves of Catha edulis Forsskal (Khat) are consumed by the people of Yemen primarily for its recreational effect, and secondarily, for achieving certain tasks. Additionally, Yemeni diabetics chew such leaves in the belief that this can control their elevated blood glucose level.

    AIMS: This review focuses on outlining the findings of studies that have been conducted to display the glycemic effect of Catha edulis, while trying to balance it with findings of the association of its chewing with the development of type 2 diabetes mellitus (DM).

    MATERIALS AND METHODS: The search strategy adopted was based on a comprehensive research in Medline, PubMed, Web of Science, JSTOR, Scopus and Cochrane for articles, proceeding abstracts and theses to identify complete reports written in the English language about the glycemic effect of Catha edulis in humans and animals from 1976 to 2016. In addition, bibliographies were also reviewed to find additional reports not otherwise published. Thirty seven records were identified of which, 25 eligible studies were included in the meta-analysis using blood glucose as an outcome measurement. Studies were divided into four subgroups according to the experimental model, namely; non-diabetic animals, diabetic animals, non-diabetic humans and diabetic humans. The pooled mean difference (MD) of blood glucose between experimental and control were calculated using random effects model of the weighted mean difference of blood glucose with 95% confidence interval (CI). Heterogeneity between studies was tested using I(2) statistic and a value of P<0.05 was considered to indicate statistical significance.

    RESULTS: The scientific reports in the literature prevailed that the glycemic effect of Catha edulis were greatly conflicting with the majority of studies indicating that Catha edulis has a mild hypoglycemic effect. However, the meta-analysis indicted that the overall result showed an insignificant reduction in blood glucose (MD=-9.70, 95% CI: -22.17 to 2.76, P=0.13, with high heterogeneity between subgroups, I(2)=88.2%, P<0.0001). In addition, pooled mean difference of blood glucose of non-diabetic animals, diabetic animals and non-diabetic humans showed an insignificant reduction in blood glucose (MD=-18.55, 95% CI: -39.55 to 2.50, P<0.08, MD=-52.13%, 95% CI: -108.24 to 3.99, P=0.07 and MD=-2.71%, 95% CI: -19.19 to -13.77, P=0.75) respectively. Conversely, a significant elevation in the pooled mean difference of blood glucose in diabetic humans was indicated (MD=67.18, 95% CI: 36.93-97.43, P<0.0001). The conflict shown in the glycemic effect of Catha edulis is thought to be cultivar-related, while demographic and epidemiological reports suggested that chewing Catha edulis might be a predisposing factor contributing to the development of type 2 DM.

    CONCLUSION: It was difficult to draw a meaningful conclusion from both the systematic and the meta-analysis with respect to the glycemic effect of Catha edulis since the meta-analysis results were insignificant with high heterogeneity among subgroups and are greatly conflicting. The variation is most likely due to unadjusted experimental factors or is related to Catha edulis itself, such as the differences in the phytochemical composition. Therefore, it is highly recommended that further studies of the glycemic effect of the cultivar of Catha edulis being studied should come with the identification and quantification of phytochemical content so that a meaningful assessment can be made with regard to its hypoglycemic properties. In addition, well-controlled clinical studies should be conducted to confirm whether or not chewing Catha edulis is associated with the development of type 2 DM, since this would be a source of concern seeing that the plant is widely consumed in certain populations.

  15. Amudha K, Choy AM, Mustafa MR, Lang CC
    Cardiovasc Ther, 2008;26(4):253-61.
    PMID: 19035876 DOI: 10.1111/j.1755-5922.2008.00064.x
    Endothelial function is impaired in healthy subjects at risk of type 2 diabetes mellitus (DM). We investigated whether endothelial dysfunction can be normalized by statin therapy in this potentially predisposed population. Flow-mediated dilation (FMD) was measured in 56 first-degree relatives (FDRs) (normotensive, normal glucose tolerance) and 20 age-, sex-, and BMI-matched controls with no family history of DM. Other measurements included insulin resistance index using the homeostasis model of insulin resistance (HOMA(IR)), plasma lipids, and markers of inflammation. The FDRs were then randomized and treated with atorvastatin (80 mg) or placebo daily in a 4-week double-blind, placebo-controlled trial. The FDRs had significantly impaired FMD (4.4 +/- 8.1% vs. 13.0 +/- 4.2%; P < 0.001), higher HOMA(IR) (1.72 +/- 1.45 vs. 1.25 +/- 0.43; P = 0.002), and elevated levels of plasma markers of inflammation-highly sensitive C-reactive protein (hsCRP) (2.6 +/- 3.8 mg/L vs. 0.7 +/- 1.0 mg/L; P = 0.06), interleukin (IL)-6 (0.07 +/- 0.13 ng/mL vs. 0.03 +/- 0.01 ng/mL; P < 0.001), and soluble intercellular adhesion molecule (sICAM) (267.7 +/- 30.7 ng/mL vs. 238.2 +/- 20.4 ng/mL; P < 0.001). FMD improved in the atorvastatin-treated subjects when compared with the placebo-treated subjects (atorvastatin, from 3.7 +/- 8.5% to 9.8 +/- 7.3%; placebo, from 3.9 +/- 5.6% to 4.7 +/- 4.2%; P = 0.001). There were also reductions in the levels of IL-6 (0.08 +/- 0.02 ng/mL vs. 0.04 +/- 0.01 ng/mL; P < 0.001) and hsCRP (3.0 +/- 3.9 mg/L vs. 1.0 +/- 1.3 mg/L; P = 0.006). Our study suggests that treatment with atorvastatin may improve endothelial function and decrease levels of inflammatory markers in FDRs of type 2 DM patients.
  16. Ashaari NS, Ramarad S, Khairuddin D, Akhir NA, Hara Y, Mahadi NM, et al.
    BMC Res Notes, 2015;8:669.
    PMID: 26563904 DOI: 10.1186/s13104-015-1637-3
    Protein microarrays have enormous potential as in vitro diagnostic tools stemming from the ability to miniaturize whilst generating maximum evaluation of diagnostically relevant information from minute amounts of sample. In this report, we present a method known as repeatable arrays of proteins using immobilized DNA microplates (RAPID-M) for high-throughput in situ protein microarray fabrication. The RAPID-M technology comprises of cell-free expression using immobilized DNA templates and in situ protein purification onto standard microarray slides.
  17. Asnawi AW, Sathar J, Mohamed R, Deraman R, Kumaran S, Hamid SS, et al.
    Indian J Hematol Blood Transfus, 2016 Jun;32(Suppl 1):251-3.
    PMID: 27408406 DOI: 10.1007/s12288-014-0495-9
    Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated. Multiple red cell alloantibodies were detected in the patient's plasma; anti-Fy a, anti-Jk b and anti-E. The patient miscarriaged and succumbed to complications of hyperhaemolysis with delayed haemolytic transfusion reaction, acute chest syndrome and renal failure. There is an urgent need for mandatory red cell antibody screen and identification especially in high-risk cases. Prevention of alloimmunization by supplying phenotype-specific red cells is also required.
  18. Atiku H, Mohamed RMSR, Al-Gheethi AA, Wurochekke AA, Kassim AHM
    Environ Sci Pollut Res Int, 2016 12;23(24):24624-24641.
    PMID: 27544526 DOI: 10.1007/s11356-016-7456-9
    The wide application of microalgae in the field of wastewater treatment and bioenergy source has improved research studies in the past years. Microalgae represent a good source of biomass and bio-products which are used in different medical and industrial activities, among them the production of high-valued products and biofuels. The present review focused on greywater treatment through the application of phycoremediation technique with microalgae and presented recent advances in technologies used for harvesting the microalgae biomass. The advantages and disadvantages of each method are discussed. The microbiological aspects of production, harvesting and utilization of microalgae biomass are viewed.
  19. Awan AAY, Berenguer MC, Bruchfeld A, Fabrizi F, Goldberg DS, Jia J, et al.
    Ann Intern Med, 2023 Dec;176(12):1648-1655.
    PMID: 38079642 DOI: 10.7326/M23-2391
    DESCRIPTION: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO.

    METHODS: The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence.

    RECOMMENDATIONS: The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.

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