Occult Hepatitis C Virus Infection among Hemodialysis Patients: An Iranian Experience

Abstract

Background: Patients with chronic kidney failure and those undergoing chronic hemodialysis (CHD) treatment are at high risk of infection with hepatitis C virus (HCV). The incidence of occult HCV infection (OCI) in CHD remains controversial and the real burden of HCV in this population may be affected by the rate of OCI. This study evaluates the molecular assessment of OCI in CHD in an Iranian population. Methods: All subjects on CHD in the South Khorasan province of Iran were invited for participation in the study. Whole blood samples were taken and serological, clinical, and demographic information was recorded. HCV-RNAs were checked in serum and peripheral blood mononuclear cells (PBMCs) using an in-house semi-nested PCR assay. Viral load was determined using a real-time PCR-based quantification kit. Sequencing was performed to determine genotypes. Results: Overall, 120 cases participated in the study; 57.5% were male and the rest were female. In serum samples, no positive case was found for HCV-RNA. In PBMC samples, 2/120 (1.6%) were positive for HCV-RNA (95% CI, 0.002 to 0.059); the mean age of OCI positive cases was 37.5 ± 19.2 years which was significantly lower than OCI negative cases (P = 0.026). Only one case had detectable viral load which was 49 IU/mL. The only HCV genotype identified was 1a. Conclusion: This study showed that there is a risk of OCI among CHD patients; the very low and undetectable viral loads of OCI warrant further follow-up molecular testing for earlier diagnosis and treatment in the era of DAA.

Prevalence of Hepatitis C Virus and Its Occult Infection in Hemodialysis Patients

“…They reported a rate of 3.36%, comparable to the current study's findings (18). The lowest prevalence of OCI in hemodialysis patients was reported by Eslamifar et al and Taherpour et al, who found prevalence rates of 0% and 1.6%, respectively (19,20). Compared to the study of Zahedi et al, in 2012, on the seroprevalence of HBV, HIV, and HCV among hemodialysis patients in Kerman, the prevalence of HCV among these patients decreased by 4% in this study (21).…”

Prognosis and Long-Term Overall Survival in Hypertensive Patients Undergoing Chronic Hemodialysis: A Multicenter Parametric Mixture Split-Population Analysis

“…It prolongs the life of patients with end-stage renal disease, improves their quality of life, and reduces death from uremia. [1][2][3] Among various comorbid illnesses associated with this problem, hypertension is mentioned as the main one. [4][5][6] According to the reports, 18-41% of patients with hypertension may need renal replacement therapy in the acute phase and the prevalence of hypertension varies from 70% to 90% among HD patients.…”