title: Utility of routine real time quantitative PCR monitoring of HCV infection in haemodialysis patients.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection causes significant morbidity and mortality in patients of end stage renal disease (ESRD) on haemodialysis (HD). Stringent screening methods can help in its early diagnosis.
  
  
  OBJECTIVE
  The study addresses the utility of real-time quantitative polymerase chain reaction (RQ-PCR) in the diagnosis and monitoring of HCV infection especially on seronegative and normal serum alanine aminotransferase (ALT) HD patients.
  
  
  METHODS
  This retrospective study was carried out from January 2010 to December 2012. Patients of ESRD on maintenance HD and on whom all the three assays HCV antibody serology, PCR and ALT were done were included in the study (n=123). Group 1 (n=57), comprised of patients with negative serology and normal ALT, and Group 2 (n=66), had either raised ALT and or a positive or equivocal serology.
  
  
  RESULTS
  Out of the 123 cases studied, HCV serology was positive in 36.5% (45), ALT raised in 18.6% (23) and PCR positive in 67.4% (83) cases. PCR positivity was significantly higher than serology and raised ALT. Group 2 had a significantly higher PCR positivity than Group 1 (P=0.0004), but 50.9% patients of Group 1, were also PCR positive and 69% of them had a high viral count of >8×10(5) IU/ml at the time of detection.
  
  
  CONCLUSIONS
  Regular routine screening of HCV by RQ-PCR in ESRD patients can help in early diagnosis of HCV infection in patients with low index of suspicion.
authors: S
authors: S
authors: Datta
authors: N
authors: N
authors: Goel
authors: Department of Clinical Microbiology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi - 110 060, India.
authors: C
authors: C
authors: Wattal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis* / Q000821:virology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult