Virological characteristics of hepatitis C virus infection in chronic hemodialysis patients: a cross-sectional study.
Detection of hepatitis C virus viremia (HCV RNA) in serum of hemodialysis (HD) patients is crucial for documenting ongoing infection because the clinical and epidemiological importance of anti-HCV positivity is not clear. HCV viremia was studied in 104 HD patients by reverse transcription polymerase chain reaction (RT PCR) using primers localized in the 5' non-coding region of the viral genome. We used two different methods to detect HCV RNA: a direct PCR amplification of HCV RNA from human serum, and a standard RT PCR procedure (requiring the RNA extraction step). There were 50 (48%) anti-HCV positive patients in this population. Twenty-two (21.1%) out of 104 patients showed HCV RNA in serum by standard RT PCR technique: they belonged to the anti-HCV positive patient group, whereas all anti-HCV negative patients were HCV RNA negative. Prevalence of HCV RNA was more than doubled when standard RT PCR was used compared to direct RT PCR protocol. There was a good association between serum HCV RNA and circulating anti-HCV antibodies, tested by second-generation ELISA and RIBA assays. HCV viremia was not associated with either the presence or the absence of a particular RIBA antibody specificity. AST and ALT levels had no predictive value for HCV viremia, because they were repeatedly normal in the majority of viremic patients (16/22: 73%).(ABSTRACT TRUNCATED AT 250 WORDS)
Fabrizi
F
F
Hospital of Lecco, Department of Hygiene and Preventive Medicine, University of Milan, Italy.
Lunghi
G
G
Guarnori
I
I
Raffaele
L
L
Di Filippo
S
S
Erba
G
G
Pagano
A
A
Locatelli
F
F
D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D015151:Immunoblotting; D007676:Kidney Failure, Chronic / Q000628:therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D013048:Specimen Handling; D014766:Viremia / Q000453:epidemiology / Q000821:virology
D018937:Hepatitis C Antibodies; D012367:RNA, Viral