Hepatitis C, HCV genotypes and hepatic siderosis in patients with chronic renal failure on haemodialysis in Brazil.
BACKGROUND
The aim of this study was to investigate the HCV genotypes, hepatic siderosis, inflammatory activity and fibrosis of the liver in patients with chronic renal failure (CRF) on haemodialysis in Brazil.


METHODS
A cohort of 72 CRF patients was compared with a group of 65 candidates for blood donation (CBD). For the subjects selected, who tested positive for anti-HCV antibodies and were HCV-PCR positive, a protocol with epidemiological, clinical and laboratory information was completed. An ultrasound-guided liver biopsy was performed and histological analysis of liver fragments was carried out. The presence of HCV-RNA in plasma was established by nested-RT-PCR. The genotype was determined by Restriction Fragment Length Polymorphism (RFLP) analysis of the PCR product.


RESULTS
HCV genotype 1 was predominant in both groups, but genotype 2 was the second most common amongst CRF patients, and there was a significant difference when compared with the CBD group (P=0.016). Regarding inflammation and fibrosis, no significant difference was observed in the histology of the liver between the study groups. Siderosis of the liver was more prevalent in the CRF group (P=0.000). Severe complications of liver biopsies were reported in 10 CRF patients (13.2%).


CONCLUSIONS
Genotype 2 was observed more frequently in the haemodialysis group. No statistically significant difference was detected between the CRF and CBD groups with regard to both inflammatory response and liver fibrosis. Hepatic siderosis has been attributed to excessive iron administration. As percutaneous liver biopsy resulted in severe complications, we suggest that other procedures of evaluating liver damage in CRF patients should be looked at thoughtfully.
de Paula Farah
Kátia
K
Infectious and Parasitic Diseases Branch, Internal Medicine Department, Medical School of the Federal University of Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil.
Carmo
Ricardo Andrade
RA
de Figueiredo Antunes
Carlos Maurício
CM
Serufo
José Carlos
JC
Nobre Júnior
Vandack Alencar
VA
Fonseca de Castro
Lúcia Porto
LP
Leite
Virgínia Hora Rios
VH
Silva
Rogério Augusto Pinto
RA
Alvares
Maria Carolina Barbosa
MC
Corrêa
Guilherme Oliveira
GO
Busek
Solange Cristina Uber
SC
Lambertucci
José Roberto
JR
D000328:Adult; D001706:Biopsy / Q000009:adverse effects; D001782:Blood Donors; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012806:Siderosis / Q000150:complications*