Hepatitis C virus (HCV) infection has been identified as the major cause of chronic liver disease among patients on chronic hemodialysis (HD), despite the important reduction in risks obtained by testing candidate blood donors for anti-HCV antibodies and the use of recombinant erythropoietin to treat anemia. A cross-sectional study was performed to estimate the prevalence of HCV infection and genotypes among HD patients in Salvador, Northeastern Brazil. Anti-HCV seroprevalence was determined by ELISA in 1243 HD patients from all ten different dialysis centers of the city. HCV infection was confirmed by RT-PCR and genotyping was performed by restriction fragment length polymorphism. Anti-HCV seroprevalence among HD patients was 10.5% (95% CI: 8.8-12.3) (Murex anti-HCV, Abbott Murex, Chicago, IL, USA). Blood samples for qualitative HCV detection and genotyping were collected from 125/130 seropositive HD patients (96.2%). HCV-RNA was detected in 92/125 (73.6%) of the anti-HCV-positive patients. HCV genotype 1 (77.9%) was the most prevalent, followed by genotype 3 (10.5%) and genotype 2 (4.6%). Mixed infections of genotypes 1 and 3 were found in 7.0% of the total number of patients. The present results indicate a significant decrease in anti-HCV prevalence from 23.8% detected in a study carried out in 1994 to 10.5% in the present study. The HCV genotype distribution was closely similar to that observed in other hemodialysis populations in Brazil, in local candidate blood donors and in other groups at risk of transfusion-transmitted infection.
IN TR O D U Ç Ã OEnvolvim ento glomerular tem sido d o cumentado em situações experimentais2 e em casos clínicos de esquistossomose mansô nica, particularm ente na form a hépato-esplê nica desta parasitose1 '5'H,q. De outra parte, acometim ento glomerular, habitualm ente assintom ático, tem sido descrito em pacientes com salmonelose*. Em áreas endêmicas de esquistossomose e de salmonelose, tem-se descrito a ocorrência de associações pe culiares destas condições, destacando-se, em nosso meio, a ocorrência de uma salmonelo se septicêmica de longa duração, com ca racterísticas clínicas e laboratoriais espe ciais12. Seria justo imaginar-se que, na vigên cia de uma situação como esta, fosse mais significante a ocorrência de acometimento glomerular. De fato, na literatura recente tem sido documentada a ocorrência de pro teinúria maciça em salmonelose crônica asso ciada à esquistossomose por S. haematob iu m 3, assim como quadro reversível de síndrome nefrótica4 .No presente trabalho resolvemos avaliar a freqüência com que o trato urinário se achava envolvido em portadores dp salmo ' Trabalho realizado n;.
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