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Comparative study of hepatitis C virus antibody between hemodialysis and continuous ambulatory peritoneal dialysis
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
Hepatitis C virus (HCV) antibody prevalence is higher in hemodialysis (HD) patients than continuous ambulatory peritoneal dialysis (CAPD) patients. HD patients with anti-HCV antibodies often show correlation with longer dialysis duration, suggesting transmission risks.
Area of Science:
- Nephrology
- Infectious Diseases
- Virology
Background:
- Hepatitis C virus (HCV) infection is a significant concern in patients undergoing renal replacement therapy.
- Antibodies to the hepatitis C virus (Anti-HCV) are key indicators of infection.
- Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) represent distinct renal replacement modalities with potentially different infection transmission risks.
Purpose of the Study:
- To determine the prevalence of anti-HCV in patients undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).
- To investigate the clinical significance and correlations of anti-HCV positivity in these patient groups.
- To assess the seroconversion rates of anti-HCV over a six-month follow-up period.
Main Methods:
- Cross-sectional and prospective study designs were employed.
- Anti-HCV antibody testing was performed on 54 HD patients and 227 CAPD patients.
- A follow-up study assessed 164 patients (50 HD, 114 CAPD) after six months for seroconversion.
Main Results:
- Anti-HCV positivity was significantly higher in the HD group (27.8%) compared to the CAPD group (5.3%).
- In HD patients, anti-HCV positivity correlated with the duration of dialysis but not with transfusion history or ALT levels.
- Over six months, one CAPD patient seroconverted from positive to negative, and two HD patients seroconverted from negative to positive.
Conclusions:
- The prevalence of anti-HCV is substantially higher among hemodialysis patients than CAPD patients.
- The duration of hemodialysis is a significant factor associated with anti-HCV positivity.
- Regular anti-HCV monitoring and isolation of positive HD patients using separate equipment are recommended to prevent HCV transmission during dialysis.
Abstract:
We have done cross sectional and prospective studies to determine the prevalence and the clinical significance of antibodies to the hepatitis C virus (Anti-HCV) in 54 hemodialysis (HD) patients and 227 continuous ambulatory peritoneal dialysis (CAPD) patients. Fifteen patients (27.8%) were anti-HCV (+) among the HD group, and twelve patients (5.3%) were anti-HCV (+) among the CAPD group. In the HD group, the positivity of anti-HCV correlated with the duration of HD, but there was no significant correlation with the history of transfusion, the amount of transfusion and abnormal alanine aminotransferase (ALT). At the follow-up study in 164 cases (HD 50 cases, CAPD 114 cases) after 6 months, one of 14 anti-HCV (+) CAPD patients was converted to anti-HCV (-) and two of 35 anti-HCV (-) HD patients were converted to anti-HCV (+). In conclusion, the prevalence of anti-HCV was significantly higher in HD patients compared to CAPD patients, and the positivity for anti-HCV in HD patients correlated with the duration of HD. A regular follow-up of anti-HCV and isolation of anti-HCV (+) HD patients with a separate machine may be needed to prevent the transmission of the hepatitis C virus during hemodialysis.