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Prevalence of antibody to hepatitis C virus in hemodialysis patients
J Hayashi1, K Nakashima, W Kajiyama
1Department of General Medicine, Kyushu University Hospital, Fukuoka, Japan.
Insights
Hepatitis C virus (HCV) infection is highly prevalent in Japanese hemodialysis patients, affecting 30.4%. Most infected patients showed normal liver function, suggesting transmission within dialysis units, not solely from transfusions.
Area of Science:
- Hepatology
- Infectious Diseases
- Nephrology
Background:
- Hepatitis C virus (HCV) infection poses a significant risk to hemodialysis patients.
- Previous studies indicated a higher prevalence of HCV in this vulnerable population.
- Understanding transmission routes is crucial for infection control in dialysis settings.
Purpose of the Study:
- To determine the prevalence of anti-HCV antibodies in Japanese hemodialysis patients.
- To investigate risk factors associated with HCV infection in this cohort.
- To assess the clinical presentation, including liver function, of HCV-infected hemodialysis patients.
Main Methods:
- Sera from 418 hemodialysis patients across six Japanese units in 1989 were tested.
- Enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies to hepatitis C virus (anti-HCV).
- Correlation analysis was performed for factors including blood transfusions, dialysis duration, and hepatitis B core antigen positivity.
Main Results:
- A high prevalence of anti-HCV (30.4%) was found, significantly exceeding that in blood donors.
- Anti-HCV positivity correlated with blood transfusions and longer dialysis duration.
- Notably, 22.1% of patients never transfused were anti-HCV positive, indicating intrahospital transmission.
- The majority (84.3%) of anti-HCV positive patients exhibited normal liver function.
Conclusions:
- Hepatitis C virus infection is highly prevalent among Japanese hemodialysis patients.
- Transmission likely occurs within dialysis units, beyond just blood transfusions.
- Routine screening and stringent infection control measures are vital in hemodialysis settings.
Abstract:
The prevalence of hepatitis C virus infection in hemodialysis patients in Japan was examined using sera from 418 patients from six dialysis units in 1989. The authors made use of an enzyme-linked immunosorbent assay (Ortho Diagnostics). Antibody to hepatitis C virus (anti-HCV) was detected in 127 patients (30.4%), the frequency varying from 20.0% to 34.9% in different units. The mean prevalence of anti-HCV was 20 times higher than that in blood donors. Anti-HCV positivity was not associated with antibody to hepatitis B core antigen, which was not a surrogate marker for non-A, non-B hepatitis agents in this study. Another striking finding of this study was that 84.3% of the anti-HCV-positive patients had normal liver function. Anti-HCV positivity correlated positively with the number of blood transfusions and increased with the duration of hemodialysis; however, it was 22.1% even in 113 patients never given blood transfusion. Acquisition of hepatitis C virus by dialysis patients is, therefore, not only through blood transfusions but also because of hepatitis C virus present within the unit itself. Liver dysfunction in the anti-HCV-positive patients was rare.