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High prevalence of occult hepatitis C infection in predialysis patients

Luís Henrique Bezerra Cavalcanti Sette1, Edmundo Pessoa de Almeida Lopes2, Nathália Campello Guedes Dos Anjos3

  • 1Nephrology-Department of Clinical Medicine, Federal University of Pernambuco, Pernambuco 50670-901, Brazil. luis.sette@ufpe.br.

World Journal of Hepatology
|February 2, 2019
PubMed

Insights

Occult hepatitis C virus (HCV) infection (OCI) affects 16.5% of predialysis patients. This infection is more common in older individuals, those with mixed chronic kidney disease (CKD) etiology, and those with prior hepatitis B virus (HBV) infection.

Area of Science:

  • Nephrology
  • Hepatology
  • Infectious Diseases

Background:

  • Occult hepatitis C virus infection (OCI) is linked to extrahepatic diseases.
  • Patients with chronic kidney disease (CKD) on hemodialysis (HD) have a higher prevalence of OCI.
  • Data on OCI in predialysis patients are lacking.

Purpose of the Study:

  • To evaluate the occurrence and epidemiological aspects of OCI in predialysis CKD patients.
  • To investigate if OCI occurs before renal replacement therapy (RRT) initiation.

Main Methods:

  • A cross-sectional study was conducted from 2015 to 2017.
  • Adult predialysis CKD patients (creatinine clearance < 60 mL/min·1.73 m2) were recruited.
  • OCI was diagnosed by negative anti-HCV antibody and positive HCV RNA in serum or peripheral blood mononuclear cells, excluding HBV, HCV, and HIV positive individuals.

Main Results:

  • The prevalence of OCI in predialysis patients was 16.5% (15 out of 91 patients).
  • OCI diagnosis was primarily achieved through peripheral blood mononuclear cell analysis.
  • OCI patients were significantly older, had mixed etiology CKD, and showed markers of previous HBV infection compared to non-OCI patients.

Conclusions:

  • OCI is present in predialysis CKD patients.
  • Elderly patients, those with mixed CKD etiology, and those with prior HBV infection are more susceptible to OCI.
  • These findings highlight the importance of screening for OCI in predialysis CKD populations.
Abstract

Keywords:
Chronic hepatitis CChronic kidney diseaseHemodialysisHepatitis C virus-RNAOccult hepatitis infectionPeripheral blood mononuclear cells

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