title: Hepatitis C virus screening and clinical monitoring of biomarkers in patients undergoing hemodialysis.
abstract: In this study, 395 volunteers were enrolled to investigate the seroprevalence of hepatitis C virus, the immunological and the alanine aminotransferase (ALT) biomarkers amongst hemodialysis patients, living in Manaus, Brazil. An overall seroprevalence of 13.9% was found in the hemodialysis patients. Analysis of seroconversion patterns demonstrated that most patients with HCV seroconverted up to 10 years following the first hemodialysis session. Anti-NS5 antibody was detectable in 60.4% of patients with HCV. A lower percentage of circulating CD3(+) and CD4(+) T-cells was found in patients seronegative for HCV, whereas a higher frequency of CD8(+) T-cells was the hallmark of patients with HCV. An overall low activation state of monocytes and eosinophils were observed in hemodialysis patients. In contrast, a higher frequency of activated neutrophils was observed in patients with HCV, selectively in the NS5+ subgroup. All hemodialysis patients had a higher percentage of activated lymphocytes, with the higher activation state in patients with NS5- reactivity. Higher ALT levels were observed in patients with HCV, especially in the NS5+ subgroup. Interestingly, the ALT levels were correlated negatively with the lymphocyte activation state, selectively in the NS5- subgroup, suggesting a protective role of these activated lymphocytes in patients with HCV. These findings reinforce the importance of the transmission of HCV among hemodialysis patients, suggesting that apart from the HCV screening, the serological and ALT biomarkers may represent important predictors of morbidity and/or mortality among patients undergoing hemodialysis.
authors.affiliation: Fundação de Hematologia e Hemoterapia do Amazonas-HEMOAM, Manaus, Amazonas, Brazil.
authors.forename: Laura Patrícia Viana
authors.initials: LP
authors.lastname: Maia
authors.forename: Olindo Assis
authors.initials: OA
authors.lastname: Martins-Filho
authors.forename: Andréa
authors.initials: A
authors.lastname: Teixeira-Carvalho
authors.forename: Elaine
authors.initials: E
authors.lastname: Speziali
authors.forename: Rolandro
authors.initials: R
authors.lastname: Vermhren
authors.forename: Edson Fonseca
authors.initials: EF
authors.lastname: Lira
authors.forename: Tatiane Amabile
authors.initials: TA
authors.lastname: Lima
authors.forename: Wornei Silva
authors.initials: WS
authors.lastname: Braga
authors.forename: Kátia Luz
authors.initials: KL
authors.lastname: Torres
authors.forename: Adriana
authors.initials: A
authors.lastname: Malheiro
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers; D001938:Brazil; D004804:Eosinophils / Q000276:immunology; D005260:Female; D016174:Hepacivirus / Q000276:immunology* / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D009504:Neutrophils / Q000276:immunology; D006435:Renal Dialysis / Q000009:adverse effects*; D016036:Seroepidemiologic Studies; D016176:T-Lymphocyte Subsets / Q000276:immunology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase