Hepatitis C virus (HCV) infection is a significant problem in the management of hemodialysis patients, with a high prevalence of HCV infection being reported in such patients.
A team from the Departments of Medicine at Christian-Albrechts University, Kiel, and the St Josef Hospital, Ruhr University, Bochum, Germany, have identified risk factors for HCV infection in hemodialysis patients.
Antibody testing and polymerase chain reaction (PCR) was also used to determine the prevalence of HCV and HCV-RNA respectively.
A total of 2796 patients from 43 dialysis centers were enrolled into the study, of whom 195 (7%) were found to be HCV-positive (HCV antibody and/or HCV-RNA positive).
A positive antibody test occurred in 171 patients (6%), while viremia was detectable in 111 patients (4%).
Of theses 111 HCV-RNA positive patients, 24 (22%) were negative for HCV antibodies.
0.8% of the study population were therefore HCV-positive, but could not be diagnosed by routine HCV antibody testing.
A standard questionnaire completed by 1717 of the patients in the study group was used to determine major risk factors for HCV infection.
This identified the number of blood transfusions individuals had received and duration of dialysis, the latter including patients who received no blood transfusions, as being major predictors of likely HCV infection.
Sequencing of the 5`untranslated region of the genome showed a dominant genotype 1 (78%) within the cohort.
|22% of HCV-positive patients had no detectable HCV antibodies |
| Gut |
Further reverse transcription-PCR of the NS5b and core region was performed to document phylogenetic analysis.
Comparing nucleic acid sequences detected by PCR, the research group found no homogeneity and thus nosocomial transmission of HCV was excluded as a possible route of infection.
Writing in the journal Gut, Dr H. Hinrichsen, one of the authors of the report, claimed that the study showed that screening for HCV antibodies alone does not exclude infection with HCV.