Interaction between blood and dialysis membrane in hepatitis-C virus-infected patients: A comparative study

Hepatitis-C virus (HCV) infection remains highly prevalent among hemodialysis (HD) patients, but there is a notable paucity of information on aspects of bio-incompatibility in those infected patients. This study aimed to answer the following question: In HD patients, does chronic HCV infection attenuate the acute inflammatory response that results from contact of patient's blood with the dialyzer membrane? We elected to investigate the contact response in the initial 15 min of a standardized single dialysis session in a before-after design. Thus, we compared magnitude of dialysis-induced changes in total leukocyte counts, platelet counts, and C3a levels in a cohort of HCV-infected and a cohort of non-infected dialysis patients (57 patients in each group). Distribution of gender, age groups, and hypertension was comparable in both HCV-infected and non-infected patients. Furthermore, the baseline pre-dialysis measurements of the studied biocompatibility markers showed statistically equivalent values in the two groups with the exception of a marginally lower platelet count among HCV-infected patients. After 15 min of HD, the total leukocyte count dropped by 16% in HCV-infected patients and by 21.5% in the non-infected group (P <0.01). However, in both groups of patients, all values remained within the customary warm zone of normal distribution of these cells in the general population. There was no statistically significant difference between the two groups in dialysis-induced thrombocytopenia or C3a levels. The magnitude of cell count reduction and complement activation in both the HCV-infected and non-infected groups of HD patients was modest and unlikely to symbolize any clinical relevance. A valid answer to our research question may be only distinctly obtained if novel molecular and sub-molecular biomarkers for detection of micro-inflammation are used.