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Occult Hepatitis C Virus Infection among Hemodialysis Patients

Guillermina Barril^*, Inmaculada Castillo, María Dolores Arenas, Mario Espinosa, Juan Garcia-Valdecasas^||, Nuria Garcia-Fernández^¶, Emilio González-Parra^**, José María Alcazar, Carmen Sánchez, José Carlos Diez-Baylón, Pilar Martinez^||||, Javier Bartolomé and Vicente Carreño

^* Department of Nephrology, Hospital de la Princesa, Fundación para el Estudio de las Hepatitis Virales, ^** Department of Nephrology, Hospital Central de la Defensa, Department of Nephrology, Hospital 12 de Octubre, Department of Nephrology, Hospital Universitario La Paz, and ^|||| ICN-FMC El Pilar, Madrid, Department of Nephrology, Clinica Perpetuo Socorro, Alicante, Department of Nephrology, Hospital Reina Sofía, Córdoba, ^|| Department of Nephrology, Hospital Clínico Universitario, Granada, ^¶ Department of Nephrology, Clínica Universitaria de Navarra, Pamplona, and Dialysis Center FRIAT, Segovia, Spain

Correspondence: Dr. Vicente Carreño, Fundación para el Estudio de las Hepatitis Virales, Guzmán el Bueno 72, 28015 Madrid, Spain. Phone: +34-91-544-60-13; Fax: +34-91-544-92-28; E-mail: fehvhpa{at}fehv.org

Received for publication March 14, 2008. Accepted for publication May 22, 2008.

Occult hepatitis C virus (HCV) infection (i.e., detectable HCV-RNA in the liver or peripheral blood mononuclear cells) in the absence of both serum HCV-RNA and anti-HCV antibodies has not been investigated in hemodialysis patients. In this study, real-time PCR and in situ hybridization was used to test for the presence of genomic and antigenomic HCV-RNA in peripheral blood mononuclear cells of 109 hemodialysis patients with abnormal levels of liver enzymes. Occult HCV infection, determined by the presence of genomic HCV-RNA, was found in 45% of the patients; 53% of these patients had ongoing HCV replication, indicated by the presence of antigenomic HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on hemodialysis and had significantly higher mean alanine aminotransferase levels during the 6 mo before study entry. Logistic regression analysis revealed that mortality was associated with age >60 yr (odds ratio 3.30; 95% confidence interval 1.05 to 10.33) and the presence of occult HCV infection (odds ratio 3.84; 95% confidence interval 1.29 to 11.43). In conclusion, the prevalence of occult HCV infection is high among hemodialysis patients with persistently abnormal values of liver enzymes of unknown cause. The clinical significance of occult HCV infection in these patients requires further study.

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Occult Hepatitis C Virus Infection in Hemodialysis

Fabrizio Fabrizi and Paul Martin
J. Am. Soc. Nephrol. 2008 19: 2248-2250. [Full Text] [PDF]

This article has been cited by other articles:

				F. Fabrizi and P. Martin Occult Hepatitis C Virus Infection in Hemodialysis J. Am. Soc. Nephrol., December 1, 2008; 19(12): 2248 - 2250. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673