title: Occult hepatitis C virus infection among hemodialysis patients.
abstract: 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.
authors.affiliation: Department of Nephrology, Hospital de Princesa, Madrid, Spain.
authors.forename: Guillermina
authors.initials: G
authors.lastname: Barril
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Castillo
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Arenas
authors.forename: Mario
authors.initials: M
authors.lastname: Espinosa
authors.forename: Juan
authors.initials: J
authors.lastname: Garcia-Valdecasas
authors.forename: Nuria
authors.initials: N
authors.lastname: Garcia-Fernández
authors.forename: Emilio
authors.initials: E
authors.lastname: González-Parra
authors.forename: José María
authors.initials: JM
authors.lastname: Alcazar
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Diez-Baylón
authors.forename: Pilar
authors.initials: P
authors.lastname: Martinez
authors.forename: Javier
authors.initials: J
authors.lastname: Bartolomé
authors.forename: Vicente
authors.initials: V
authors.lastname: Carreño
mesh_terms: 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
chemical_list: D012367:RNA, Viral; D000410:Alanine Transaminase