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[Prevalence of hepatitis C virus infection among chronic hemodialysis patients]
1Third Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
A high prevalence of HCV (hepatitis C virus) antibodies have been reported in chronic hemodialysis (HD) patients. In this study, sera from 584 hemodialysis patients (378 males and 206 females) were examined for the 2nd generation HCV antibody by enzyme immunoassay (EIA) and for HCV-RNA by the reverse transcription-polymerase chain reaction (RT-PCR) method. The positive rates of HCV antibody and HCV-RNA were 22.0% (129/584) and 12.3% (72/584), respectively. In HD patients, HCV infections were considered to be caused by the contact with contaminated blood samples, the main cause of which is blood transfusions. However, a high prevalence of HCV markers even in HD patients without a history of blood transfusions indicates that there may be other ways of HCV transmission other than blood transfusions. While HCV-RNA was detected in about 50% of the HD patients with the HCV antibody, this rate was lower than that found in the general population with the HCV antibody. And the abnormality rate of serum alanine aminotransferase (ALT) in HD patients with HCV-RNA was lower than that of the general population with HCV-RNA. On the other hand, the amounts of HCV-RNA which were semiquantified by RT-PCR using the end-point dilution method showed a correlation with serum ALT levels in both HD patients and chronic HCV infections. Moreover, HCV-RNA titers measured immediately after hemodialysis showed a marked decrease compared with those measured before hemodialysis. These results suggest that HCV was eliminated to certain extent with hemodialysis and that it might also be the cause of the low abnormality rate of serum ALT in HD patients with HCV-RNA.
A high prevalence of HCV (hepatitis C virus) antibodies have been reported in chronic hemodialysis (HD) patients. In this study, sera from 584 hemodialysis patients (378 males and 206 females) were examined for the 2nd generation HCV antibody by enzyme immunoassay (EIA) and for HCV-RNA by the reverse transcription-polymerase chain reaction (RT-PCR) method. The positive rates of HCV antibody and HCV-RNA were 22.0% (129/584) and 12.3% (72/584), respectively. In HD patients, HCV infections were considered to be caused by the contact with contaminated blood samples, the main cause of which is blood transfusions. However, a high prevalence of HCV markers even in HD patients without a history of blood transfusions indicates that there may be other ways of HCV transmission other than blood transfusions. While HCV-RNA was detected in about 50% of the HD patients with the HCV antibody, this rate was lower than that found in the general population with the HCV antibody. And the abnormality rate of serum alanine aminotransferase (ALT) in HD patients with HCV-RNA was lower than that of the general population with HCV-RNA. On the other hand, the amounts of HCV-RNA which were semiquantified by RT-PCR using the end-point dilution method showed a correlation with serum ALT levels in both HD patients and chronic HCV infections. Moreover, HCV-RNA titers measured immediately after hemodialysis showed a marked decrease compared with those measured before hemodialysis. These results suggest that HCV was eliminated to certain extent with hemodialysis and that it might also be the cause of the low abnormality rate of serum ALT in HD patients with HCV-RNA.