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Hepatitis C virus in renal disease
C L Davis1, D R Gretch, R L Carithers
1University of Washington Medical Center, Transplantation Services, Seattle 98195.
Insights
Hepatitis C virus (HCV) infection is common in dialysis patients and can cause kidney disease. New diagnostic methods are needed to track HCV in patients with end-stage renal disease after transplantation.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis C virus (HCV) is a primary cause of liver disease in patients undergoing dialysis and those who have received kidney transplants.
- An estimated 20% to 30% of the dialysis population is infected with HCV.
- HCV is implicated in the development of kidney conditions like membranoproliferative and membranous glomerulonephritis.
Purpose of the Study:
- To evaluate the diagnostic utility of current methods for Hepatitis C virus (HCV) detection in end-stage renal disease (ESRD) patients.
- To understand the natural history of HCV infection in ESRD patients, particularly after renal transplantation, using updated viral markers.
Main Methods:
- Utilized enzyme immunoassay (EIA) and recombinant immunoblot assay (RIBA) to detect antibodies against multiple HCV antigens.
- Employed polymerase chain reaction (PCR) for Hepatitis C virus RNA identification, especially post-transplantation.
- Reviewed existing literature on HCV diagnosis and natural history in the context of ESRD.
Main Results:
- EIA and RIBA are effective in diagnosing HCV infection in dialysis patients.
- Post-transplantation, HCV RNA detection via PCR is frequently necessary for accurate diagnosis.
- The long-term course of HCV infection with new markers in ESRD patients requires further definition.
Conclusions:
- Current serological tests are valuable for initial HCV diagnosis in dialysis patients.
- Molecular methods like PCR are crucial for confirming HCV infection after kidney transplantation.
- Further research is essential to define the natural history of HCV in ESRD patients with advanced diagnostic tools.
Abstract:
Hepatitis C virus (HCV) is the most frequent cause of liver disease in dialysis and renal transplant recipients. Approximately 20% to 30% of the dialysis population is infected with HCV. HCV is also recognized as a cause of membranoproliferative and membranous glomerulonephritis. Enzyme immunoassay or recombinant immunoblot assay identify antibodies to multiple HCV antigens and are useful in the diagnosis of HCV infection, including infections in dialysis patients. However, after transplantation, HCV RNA identification by polymerase chain reaction is often required to detect the infection. The natural history of HCV infection using the new viral markers remains to be defined in patients treated for end-stage renal disease.