Clinical and laboratory characteristics of acute hepatitis C in patients with end-stage renal disease on hemodialysis.
BACKGROUND
Patients with end-stage renal disease (ESRD) undergoing hemodialysis are a risk group for hepatitis C virus (HCV) infection. The characteristics of acute hepatitis C infection in this population are not well known.


OBJECTIVE
To evaluate the clinical and laboratory characteristics of acute hepatitis C in ESRD patients treated with hemodialysis.


METHODS
ESRD patients on hemodialysis with acute hepatitis C, characterized by elevated alanine aminotransferase (ALT) followed by anti-HCV seroconversion were studied.


RESULTS
Thirty-six patients (58% females, 44+/-12 y), with a mean time on hemodialysis of 2 years, were included. Only 2 (6%) patients had jaundice. ALT elevation was observed in all patients. Median peak ALT was 4.7 x upper limit of normal. The median interval between ALT elevation and anti-HCV seroconversion was 1 month (0 to 8). None of the patients with detectable HCV-RNA showed spontaneous clearance of viremia within 12 weeks of follow-up. Three (8%) patients presented ALT elevation followed by anti-HCV seroconversion with undetectable HCV-RNA.


CONCLUSIONS
Acute hepatitis C is frequently asymptomatic in ESRD patients on hemodialysis and should be suspected in all patients presenting elevated ALT. Determination of HCV-RNA is important for the confirmation of infection. Anti-HCV seroconversion seems to occur early and spontaneous clearance of HCV-RNA is uncommon.
Lemos
Lara B
LB
Division of Gastroenterology, Federal University of São Paulo, Brazil.
Perez
Renata M
RM
Matos
Carla A L
CA
Silva
Ivonete S
IS
Silva
Antonio Eduardo B
AE
Ferraz
Maria Lucia G
ML
D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D018450:Disease Progression; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D006435:Renal Dialysis; D013997:Time Factors
D012367:RNA, Viral; D000410:Alanine Transaminase