Occult hepatitis C virus infection among hemodialysis patients.
Occult hepatitis C virus (HCV) infection (i.e., detectable HCV-RNA in the liver or peripheral blood mononuclear cells) in the absence of both serum HCV-RNA and anti-HCV antibodies has not been investigated in hemodialysis patients. In this study, real-time PCR and in situ hybridization was used to test for the presence of genomic and antigenomic HCV-RNA in peripheral blood mononuclear cells of 109 hemodialysis patients with abnormal levels of liver enzymes. Occult HCV infection, determined by the presence of genomic HCV-RNA, was found in 45% of the patients; 53% of these patients had ongoing HCV replication, indicated by the presence of antigenomic HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on hemodialysis and had significantly higher mean alanine aminotransferase levels during the 6 mo before study entry. Logistic regression analysis revealed that mortality was associated with age >60 yr (odds ratio 3.30; 95% confidence interval 1.05 to 10.33) and the presence of occult HCV infection (odds ratio 3.84; 95% confidence interval 1.29 to 11.43). In conclusion, the prevalence of occult HCV infection is high among hemodialysis patients with persistently abnormal values of liver enzymes of unknown cause. The clinical significance of occult HCV infection in these patients requires further study.
Barril
Guillermina
G
Department of Nephrology, Hospital de Princesa, Madrid, Spain.
Castillo
Inmaculada
I
Arenas
María Dolores
MD
Espinosa
Mario
M
Garcia-Valdecasas
Juan
J
Garcia-Fernández
Nuria
N
González-Parra
Emilio
E
Alcazar
José María
JM
Sánchez
Carmen
C
Diez-Baylón
José Carlos
JC
Martinez
Pilar
P
Bartolomé
Javier
J
Carreño
Vicente
V
D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D005260:Female; D016174:Hepacivirus / Q000378:metabolism*; D006526:Hepatitis C / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010802:Phylogeny; D012367:RNA, Viral / Q000378:metabolism; D012044:Regression Analysis; D006435:Renal Dialysis; D017422:Sequence Analysis, DNA
D012367:RNA, Viral; D000410:Alanine Transaminase