Hepatitis C infection in dialysis patients in Israel.
BACKGROUND
Hepatitis C virus is the major cause of acute and chronic hepatitis in patients with end-stage renal disease receiving replacement therapy.


OBJECTIVE
To define the prevalence of HCV RNA in a population of patients on dialysis in Israel, to determine the relative risk of acquiring HCV infection while treated by hemodialysis or chronic ambulatory peritoneal dialysis, and to define the HCV genotypes in this population.


METHODS
During 1995 we studied 162 dialysis patients. Information was obtained regarding the mode of dialysis, years of treatment, number of blood transfusions, and results of serological testing for HCV, hepatitis B virus, and human immunodeficiency virus. Anti-HCV antibodies were tested by a third-generation microparticle enzyme immunoassay. HCV RNA was determined by polymerase chain reaction. HCV genotyping was performed by a hybridization assay.


RESULTS
HCV RNA was detected in 18% of the HD group and 7% of the CAPD group. The number of HCV RNA-positive patients was significantly higher in the HD than the CAPD group (P < 0.05). HCV RNA-positive HD patients were treated longer than the HCV RNA-negative patients (P < 0.02).


CONCLUSIONS
Third-generation immunoassay proved to be highly sensitive (94%) and specific (91%) in identifying HCV RNA positivity. Several HCV subtypes were detected, 1b being the most frequent. Identification and isolation of infected HCV patients may minimize its spread in dialysis units and prevent cross-infection.
Weinstein
T
T
Department of Nephrology, Golda Campus, Rabin Medical Center, Petah Tiqva, Israel.
Tur-Kaspa
R
R
Chagnac
A
A
Korzets
A
A
Ori
Y
Y
Zevin
D
D
Herman
M
M
Gafter
U
U
D000328:Adult; D000368:Aged; D001706:Biopsy; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control / Q000821:virology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007124:Immunoenzyme Techniques; D017053:Infection Control; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D006435:Renal Dialysis / Q000009:adverse effects*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D013997:Time Factors
D018937:Hepatitis C Antibodies; D012367:RNA, Viral