title: Hepatitis C Virus Infection in Haemodialysis Patients: "Wolf in Sheep's Clothing".
abstract: BACKGROUND
  170 million people are infected with the Hepatitis C virus (HCV) around the world. Approximately 50%-70% patients infected with HCV develop chronic liver disease. Haemodialysis patients constitute an especially important group with high HCV prevalence. Outbreaks of HCV infection in dialysis units have been documented. Detection of anti-HCV antibodies is a convenient and conventional mode of documentation. However, in this group, it has it's own caveats.
  
  
  METHODS
  48 patients who had undergone or were on haemodialysis (HD) and had undergone a minimum of 15 dialysis sittings were studied. HCV infection was documented both by anti-HCV antibody detection and HCV RNA testing. A comparative evaluation of results by both tests was done.
  
  
  RESULTS
  Out of a total of 48 patients, HCV RNA was detected in 38 (79.16%) and anti-HCV antibodies in 13(27.07%). Out of 48 patients 10(20.83%) were negative for both parameters. 22.91% (11/48) of patients were positive for both HCV RNA and anti-HCV antibody. 56.25% (27/48) were HCV RNA positive but anti-HCV antibodies were not detectable in their sera. 2 patients (04.16%) had a positive anti-HCV antibody status despite HCV RNA being negative. In 20.83% (10/48) both parameters were undetectable.
  
  
  CONCLUSIONS
  Chronic liver disease (CLD), particularly due to HCV infection, is a major complication amongst haemodialysis (HD) patients. Without reliable assays for antigenemia and the inability of antibody tests to define viremia in all cases, the detection of viral nucleic acid is necessary for diagnosis of active HCV infection.
authors.affiliation: Senior Advisor (Pathology and Immunology), Army Hospital (R&R), Armed Forces Medical College, Pune-40.
authors.forename: G S
authors.initials: GS
authors.lastname: Chopra
authors.affiliation: Reader, Department of Microbiology, Armed Forces Medical College, Pune-40.
authors.forename: R M
authors.initials: RM
authors.lastname: Gupta
authors.affiliation: Senior Adviser (Medicine and Nephrology), Military Hospital, Bareily.
authors.forename: S R
authors.initials: SR
authors.lastname: Gedela
authors.affiliation: Senior Advisor (Medicine and Nephrology), Army Hospital (R&R), Armed Forces Medical College, Pune-40.
authors.forename: P P
authors.initials: PP
authors.lastname: Varma
authors.affiliation: Director General Medical Services (Army), New Delhi.
authors.forename: R
authors.initials: R
authors.lastname: Rai
authors.affiliation: Professor and Head, Dept of Pathology, Armed Forces Medical College, Pune-40.
authors.forename: S K
authors.initials: SK
authors.lastname: Nema
keywords: Haemodialysis; Hepatitis C virus