title: Occult hepatitis C virus infection in Iranian hemodialysis patients.
abstract: BACKGROUND
  Occult hepatitis C virus (HCV) infection is defined as the presence of HCV-RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Low concentrations of HCV-RNA may be detected in PBMCs of hemodialysis (HD) patients and this could have a great impact on the management of HD patients.
  
  
  OBJECTIVE
  The aim of this study was to detect the occult HCV infection in Iranian HD patients.
  
  
  METHODS
  A total of 70 anti-HCV negative HD patients from three dialysis units in Tehran, Iran were included in this study. In these cases, presence of HCV-RNA in plasma samples was tested by reverse transcriptase-nested polymerase chain reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCV-RNA, genomic HCV-RNA was checked in PBMC specimens by RT-nested PCR.
  
  
  RESULTS
  Seventy anti-HCV negative HD patients were enrolled in the study. 32.85% and 1.43% of cases had elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) respectively. 7.14% of patients had elevated levels of both ALT and AST. HCV-RNA was negative in plasma samples of all anti-HCV negative HD subjects. The genomic HCV-RNA was not detected in any PBMC samples of HD cases with negative anti-HCV and plasma HCV-RNA.
  
  
  CONCLUSIONS
  Occult HCV infection was not detected in our HD patients despite of elevated levels of liver enzymes in some participants. Further studies involving larger number of HD patients are required to elucidate the rate of occult HCV infection in HD cases.
authors.affiliation: Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Eslamifar
authors.affiliation: Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Amitis
authors.initials: A
authors.lastname: Ramezani
authors.affiliation: Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Ehteram
authors.affiliation: Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Effat
authors.initials: E
authors.lastname: Razeghi
authors.affiliation: Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farrokhlagha
authors.initials: F
authors.lastname: Ahmadi
authors.affiliation: Nephrology Department, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Amini
authors.affiliation: Iranian Society for Support of Patients with Infectious Diseases, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Banifazl
authors.affiliation: Chamran Hospital, Tehran, Iran.
authors.forename: Gelavizh
authors.initials: G
authors.lastname: Etemadi
authors.affiliation: Department of Virology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
authors.affiliation: Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Anahita
authors.initials: A
authors.lastname: Bavand
authors.affiliation: Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Aghakhani
keywords: HCV-RNA; Hemodialysis (HD); Hepatitis C virus (HCV)