Reappraisal of biochemical hepatitis C activity in hemodialysis patients.
We reappraised biochemical hepatitis C activity in hemodialysis patients in comparison with normal controls. A total of 111 hemodialysis patients and 66 healthy volunteer blood donors with hepatitis C virus (HCV) infection were consecutively enrolled. Serum alanine aminotransferase (ALT) levels were normal (< or =45 U/L) in 103 (93%) hemodialysis patients and 34 (52%) donors (p < 0.001). HCV viremic levels were lower in the hemodialysis group (p = 0.044), with no difference in the HCV genotype prevalence. During two-year follow-up, 60 (67%) of 90 hemodialysis patients and 13 (26%) of 50 donors showed persistently normal ALT levels (p < 0.001). For hemodialysis patients, however, the upper normal limit of ALT activity was reset at 25 U/L corresponding to the mean + 2 x SD for the normalized ALT distribution in 400 control patients. The adjusted ALT levels were initially normal in 73 (66%) hemodialysis patients and persistently normal in 19 (21%). Thus, ALT levels were the same for the two groups. GB virus C (GBV-C)/hepatitis G virus (HGV) coinfection found only in the hemodialysis group (10/111) had no influence on the disease. A relationship was noted between low disease activity and female gender in both groups. These findings indicate that biochemical hepatitis C activity in hemodialysis patients is similar to that in normal controls and should be monitored based on adjusted ALT levels.
Yuki
N
N
Department of Gastroenterology, Osaka National Hospital, Japan.
Ishida
H
H
Inoue
T
T
Tabata
T
T
Matsushita
Y
Y
Kishimoto
H
H
Kato
M
M
Masuzawa
M
M
Sasaki
Y
Y
Hayashi
N
N
Hori
M
M
D000410:Alanine Transaminase / Q000097:blood*; D016022:Case-Control Studies; D004796:Clinical Enzyme Tests; D005260:Female; D018067:Flaviviridae; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D006435:Renal Dialysis; D013997:Time Factors
D000410:Alanine Transaminase