Prevalence of hepatitis C virus infection in hemodialysis patients: A longitudinal study comparing the results of RNA and antibody assays

Abstract

We longitudinally studied 51 patients from two hemodialysis centers to determine the prevalence of hepatitis C virus infection in hemodialysis patients. Serum samples were tested for antibody to HCV by first- and second-generation enzyme immunoassays and for hepatitis C virus RNA by nested polymerase chain reaction assay. Antibody to hepatitis C virus was detected in the initial serum samples by first-generation enzyme immunoassay and second-generation enzyme immunoassay in 6 (11.8%) and 11 (21.6%) patients, respectively. First-generation enzyme immunoassay had a false-positive rate of 33.3% and a false-negative rate of 63.6%. Hepatitis C virus RNA was found in eight second-generation enzyme immunoassay-positive patients (72.7%) and in one patient negative for antibody to hepatitis C virus (2.5%) giving an overall positivity rate of 17.6%. After 19 mo, antibody to hepatitis C virus was detected in 15 patients (29.4%) on second-generation enzyme immunoassay; hepatitis C virus RNA was found in 13 patients (25.5%). Hepatitis C virus markers persisted in all 12 patients with initial evidence of hepatitis C virus infection. Three patients acquired hepatitis C virus infection during the interim, giving a new infection rate of 4.9% per patient-year. Antibody to hepatitis C virus, hepatitis C virus RNA or both was detected in 55.6% of patients with biochemical changes suggestive of non-A, non-B hepatitis. Of the 15 antibody to hepatitis C virus, second-generation enzyme immunoassay-positive patients, 66.7% had persistently normal serum transaminase levels. In summary, hepatitis C virus infection is common among hemodialysis patients. First-generation enzyme immunoassay is an unreliable assay for antibody to hepatitis C virus in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence and Characterization of Hepatitis C Virus in Hemodialysis Patients.

“…The majority of HDpatients with HCVhave only a minimal derangement in the ALTlevel (1,6). However, recent histological analysis of the liver tissue indicates that HDpatients with HCVoften have chronic active hepatitis or cirrhosis (7,8).…”

“…In fact, previous studies have demonstrated that as manyas 10 to 40%of HDpatients are chronically infected by HCV,although HCV prevalence in HDpatients is highly variable among different countries and even amongHDunits in the same area (1)(2)(3). The high prevalence of HCVin HDpatients is believed to be attributed to the transfusion of HCV-contaminated blood products before the availability of reliable HCVscreening.…”

“…The levels of serum aminotransferases are usually normal or only slightly elevated in HDpatients with HCV (1,6). Uremia is considered to predispose a patient to a chronic viral carrier status with little inflammatory activity in the liver.…”

Hepatitis B and Hepatitis C Virus Infection among End Stage Renal Disease Patients on Maintenance Hemodialysis, Their Family Members and Dialysis Staffs - A Prevalence Study

“…The prevalence of HCV infection increases from 12% to 37% after five years on HD. 10 In this study it was also identified that HCV positivity was more in longer duration dialyzed patients. Although two-thirds of the patients were on BT but that did not have any significant influence on prevalence of the hepatitis viruses.…”

High prevalence of hepatitis C virus-ribonucleic acid positivity in anti-hepatitis C virus negative renal transplant patients

“…non-establishment of a carrier state, low-level undetectable viraemia, and intermittent viraemia. 15,17 The former is more likely in RT patients and the latter two are more likely in a dialysis setting. In our study HCV-RNA was undetectable in 8.3% of the patients with a positive serology.…”