title: Hepatitis C virus (HCV) Infection Rate among Seronegative Hemodialysis Patients Screened by Two Methods; HCV Core Antigen and Polymerase Chain Reaction.
abstract: BACKGROUND
  End-stage renal disease patients on chronic hemodialysis are among high risk groups for hepatitis C virus (HCV) infection for whom routine HCV screening is recommended. Anti-HCV antibody (ab) testing may not be reliable to detect all infected cases because of the blunted ab response due to depressed immune state in these patients. Using a more reliable, cost-effective and non-complex HCV screening test may be necessary in this group of patients for case finding and management, and also for prevention of infection spread.
  
  
  OBJECTIVE
  The aim of this study was to find the prevalence of HCV infection in HCV ab negative hemodialysis patients by Real time PCR and total HCV core antigen (ag) test and comparing the results of the two tests.
  
  
  METHODS
  From a single hemodialysis center, 181 anti- HCV ab negative patients were screened by total HCV core ag using an ELISA kit. Real time PCR was used for determination of the virus and viral load quantity.
  
  
  RESULTS
  Among the 181 anti-HCV ab negative patients, 13 (7.2%) were positive for HCV core ag and 11 (6%) had detectable HCV RNA with a range of 40-336543 IU/ml by PCR. The two tests had a high measurement agreement (Kappa=0.82, P<0.001). Of the 13 patients with positive HCV core ag test results, 3 were negative for HCV RNA. Considering real time PCR for HCV RNA as the gold standard for HCV infection determination in this patient population, HCV core ag assay yielded a sensitivity of 90.9%, specificity of 98.2%, positive predictive value of 76.9% and negative predictive value of 99.4%.
  
  
  CONCLUSIONS
  The rate of HCV infection among HCV ab negative hemodialysis patients was high. HCV core ag testing could be used as a sensitive method for HCV infection screening in this group of patients.
authors.affiliation: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Moini
authors.forename: Mazyar
authors.initials: M
authors.lastname: Ziyaeyan
authors.forename: Shapoor
authors.initials: S
authors.lastname: Aghaei
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Sagheb
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Taghavi
authors.forename: Mahsa
authors.initials: M
authors.lastname: Moeini
authors.forename: Marzieh
authors.initials: M
authors.lastname: Jamalidoust
authors.forename: Laleh
authors.initials: L
authors.lastname: Hamidpour
keywords: Core Antigen; Hemodialysis; Hepatitis C Virus; Polymerase Chain Reaction
references.citation: Hemodial Int. 2012 Jul;16(3):420-7
references.pmid: 22360424
references.citation: Indian J Med Microbiol. 2006 Jan;24(1):55-7
references.pmid: 16505558
references.citation: J Clin Microbiol. 2005 Jan;43(1):414-20
references.pmid: 15635003
references.citation: Semin Dial. 2007 Sep-Oct;20(5):416-22
references.pmid: 17897248
references.citation: Hepat Res Treat. 2012;2012:832021
references.pmid: 23304475
references.citation: Hemodial Int. 2010 Jul;14(3):253-62
references.pmid: 20491973
references.citation: J Virol. 2001 Sep;75(17):8240-50
references.pmid: 11483769
references.citation: J Viral Hepat. 2007 Oct;14(10):697-703
references.pmid: 17875004
references.citation: J Med Virol. 2005 Dec;77(4):502-8
references.pmid: 16254976
references.citation: Aliment Pharmacol Ther. 2006 Nov 15;24(10):1413-22
references.pmid: 17081162
references.citation: Hepat Mon. 2012 Oct;12(10 HCC):e6894
references.pmid: 23233864
references.citation: N Engl J Med. 1992 Aug 6;327(6):369-73
references.pmid: 1320736
references.citation: J Hepatol. 1995 Dec;23(6):742-5
references.pmid: 8750176
references.citation: J Clin Microbiol. 1999 Jun;37(6):1802-8
references.pmid: 10325327
references.citation: Transfus Med. 2002 Apr;12(2):107-13
references.pmid: 11982963
references.citation: Hepatology. 2004 Apr;39(4):1147-71
references.pmid: 15057920
references.citation: Transplantation. 2010 Dec 15;90(11):1165-71
references.pmid: 20861806
references.citation: Int J Infect Dis. 2010 Sep;14 Suppl 3:e113-6
references.pmid: 20362479
references.citation: Hepatology. 1993 Sep;18(3):497-502
references.pmid: 7689528
references.citation: Singapore Med J. 2008 Nov;49(11):921-3
references.pmid: 19037560
references.citation: Am J Nephrol. 2008;28(4):628-40
references.pmid: 18285684
references.citation: Transfusion. 2000 Oct;40(10):1198-202
references.pmid: 11061855
references.citation: Transplantation. 2010 Aug 27;90(4):407-11
references.pmid: 20571469
references.citation: J Med Virol. 2004 Jul;73(3):397-403
references.pmid: 15170635
references.citation: J Clin Microbiol. 2001 Sep;39(9):3110-4
references.pmid: 11526137
references.citation: Hepatology. 2000 Aug;32(2):388-93
references.pmid: 10915747
references.citation: Saudi J Kidney Dis Transpl. 2007 Mar;18(1):107-13
references.pmid: 17237902
references.citation: Hepat Mon. 2011 Apr;11(4):247-54
references.pmid: 22087151
references.citation: Gut. 1996 Dec;39(6):876-80
references.pmid: 9038674
references.citation: J Clin Virol. 2010 May;48(1):18-21
references.pmid: 20233674
references.citation: Clin Biochem. 2008 May;41(7-8):447-52
references.pmid: 18267117
references.citation: Gastroenterology. 1996 Apr;110(4):1120-6
references.pmid: 8613001