title: Detection of hepatitis C virus in patients with terminal renal disease undergoing dialysis in southern Brazil: prevalence, risk factors, genotypes, and viral load dynamics in hemodialysis patients.
abstract: Hepatitis C (HCV) is a serious public health issue, and it is estimated that 3% of the world's population is infected. Patients in hemodialysis units have an increased risk for contracting HCV, and high prevalence rates have been found in hemodialysis units around the world. This study is aimed at determining the prevalence of HCV in patients with terminal chronic renal disease (tCRD) who have been submitted to hemodialysis and peritoneal dialysis in southern Brazil to characterize the most prevalent genotypes, the viral load, and possible risk factors and to assess the validity between the ELISA and RT-PCR detection methods. Of 320 patients from three dialysis units, 318 participated in this study. According to the medical records, 55 patients were reactive to HCV, as determined via ELISA. All 318 samples were submitted to RT-PCR and genotyped using an Abbott Realtime m2000 system. Data obtained through a questionnaire and chemical variables were associated with the HCV.
  
  
  RESULTS
  The prevalence of HCV was 18.24% (58), and the concordance between the HCV serology and the RT-PCR was 94%. Three patients were diagnosed to be negative for HCV using the ELISA assay but positive when using RT-PCR. Genotype 1 was the most prevalent (46.7%) genotype, within which subtype 1a was the most frequent (74.1%). One of the risk factors associated with HCV infection was the length of time that the patient had been undergoing hemodialysis treatments (p < 0.001). Additionally, the viral load was found to vary when tested before and after hemodialysis (p < 0.001).
  
  
  CONCLUSIONS
  The prevalence of HCV in dialysis units continues to remain high, indicating nosocomial contamination. RT-PCR detected the presence of the hepatitis C virus in patients with a non-reactive serology, which highlights the importance of performing molecular tests on dialysis patients. The variation in the viral load in patients submitted to hemodialysis indicates a possible destruction or gripping of viral particles to the dialyzer membrane.
authors: Federal University of Rio Grande (FURG), Rio Grande, Brazil. bea-dy@hotmail.com.
authors: Beatris Maria
authors: BM
authors: Vidales-Braz
authors: Federal University of Rio Grande (FURG), Rio Grande, Brazil. nayleoliveira@gmail.com.
authors: Naylê Maria Oliveira
authors: NM
authors: da Silva
authors: Federal University of Rio Grande (FURG), Rio Grande, Brazil. rubenslobatobio@gmail.com.
authors: Rubens
authors: R
authors: Lobato
authors: Fluminense Federal University (UFF), Rio de Janeiro, Brazil. bio.fngermano@gmail.com.
authors: Fabiana Nunes
authors: FN
authors: Germano
authors: Federal University of Rio Grande (FURG), Rio Grande, Brazil. Luisadias_sixcp@hotmail.com.
authors: Luiza Dias
authors: LD
authors: da Mota
authors: Federal University of Rio Grande do Sul (UFRGS), Porto alegre, Brazil. elvino.barros@gmail.com.
authors: Elvino J G
authors: EJ
authors: Barros
authors: Federal University of Rio Grande (FURG), Rio Grande, Brazil. nani60@gmail.com.
authors: Ana Maria Barral
authors: AM
authors: de Martinez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D019562:Viral Load
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral
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