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HCV-RNA Pcr Positivity In Hcv Antibody Negative Patients Undergoing Haemodialysis
Ismaa Ghazanfar Kiani1, Adil Naseer Khan2, Batool Butt1
1Military Hospital, Rawalpindi, Pakistan.
Insights
Hepatitis C virus (HCV) infection is common in haemodialysis patients. PCR testing is crucial for detecting HCV in serologically negative individuals, improving patient care.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) affects 2.2% of the global population.
- HCV is a leading cause of chronic liver disease in haemodialysis patients.
- HCV can be present without detectable antibodies.
Purpose of the Study:
- To determine the frequency of HCV infection in haemodialysis patients.
- To identify HCV in patients who are serologically negative using PCR.
Main Methods:
- Cross-sectional study conducted from June to December 2016.
- Epidemiological data collected from 201 haemodialysis patients.
- Patients tested for Anti-HCV antibodies (ELISA) and HCV RNA (PCR).
Main Results:
- 17 out of 73 (23%) ELISA-negative patients were PCR-positive for HCV.
- The majority of PCR-positive patients were male (76.5%).
- Hypertension was the most common cause of chronic kidney disease (64.7%).
Conclusions:
- PCR detection of HCV-RNA is essential for accurate diagnosis in haemodialysis patients.
- Standard of care should include PCR for HCV detection in this population.
Background:
It's estimated that almost 2.2% of the world's inhabitants suffer from hepatitis C virus (HCV). The most common cause of chronic liver disease in haemodialysis centres is due to HCV. In 1993, it was first described by Bukh and colleagues that HCV viremia can occur without any detectable antibodies to the HCV. Keeping this in mind the purpose of this cross-sectional study was to assess the frequency of HCV in haemodialysis patients by PCR who are serologically negative for HCV.
Methods:
This cross-sectional study was conducted from 1st June to 31st December 2016 on all haemodialysis patients at MH Rawalpindi. Epidemiological data for gender, age, duration on haemodialysis, cause of chronic renal failure and any associated risk factor for acquiring hepatitis C infection was asked. Patients undergoing haemodialysis were investigated by fourth generation ELISA for Anti HCV antibodies, HCV DNA polymerase chain reaction, HCV genotype (where required) and liver function test were also done.
Results:
A total of 201 patients were undergoing haemodialysis. Among these patients 73 were hepatitis "C" negative and 128 were hepatitis "C" positive. Among the 73 patients who were hepatitis C negative by ELISA method 17 (23%) were PCR positive. Of the 17 patients 13 (76.5%) were men and 4 (23.5%) were women. The mean age of the patients was 49.7±18.0 years and mean duration of haemodialysis was 4.4±4.1 months. The most common cause of CKD requiring haemodialysis was hypertension (64.7%). The most common genotype was type 1 (58.8%) followed by genotype 3 (41.2%). The mean viral load was 23583615.70 IU.
Conclusions:
HCV-RNA detection by PCR should be used as standard of care to detect HCV infection in patients undergoing haemodialysis.
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