[Viral hepatitis C in patients with terminal chronic renal insufficiency. III. Viral quantification]

We have previously shown that the prevalence of hepatitis associated with the hepatitis C virus (HCV) in patients with end stage renal disease in our institution is 10.2%. However, quantification of viral RNA in plasma and its relation with clinical variables has never been studied in our patients. Thus, the aim of the present work was to quantify the HCV viral load in patients with ESRD in dialysis, and to correlate these values with the dialysis modality and the viral genotype.

We performed a transverse, prospective and comparative study in patients with HCV infection in hemodialysis, continuous ambulatory peritoneal dialysis and patients in peritoneal dialysis, but with history of hemodialysis. Viral load was quantified with RT-PCR by using a commercial kit known as Amplicor HCV 2.0. Clinical variables studied were: age, gender, end stage renal disease etiology, modality and time in dialysis, transfusions, serum albumin, aminotransferases, blood urea nitrogen, and serum creatinine.

Twenty four patients in dialysis with HCV infection entered into the study. Of these patients, 25% were on peritoneal dialysis, 29% on peritoneal dialysis with history of hemodialysis, and 46% were in hemodialysis. The average viral load (copies x 10(6)/mL) was 1.41 +/- 3.01. Viral load was lower in patients on peritoneal dialysis than in patients treated, or with history of hemodialysis (0.20 +/- 0.12 vs 2.04 +/- 0.88; p < 0.05). We observed no differences in viral load among patients with different viral genotypes.

The average viral load of our patients in dialysis is lower than the levels usually observed in hepatitis C infected patients without end stage renal disease. The lower viral load in patients treated with peritoneal dialysis, and no history of hemodialysis, probably denotes lower risk of chronic liver disease in these subpopulation.