Abnormal Alanine Aminotransferase Activity Reflects Exposure to Hepatitis C Virus in Haemodialysis Patients

Abstract

Prospective studies have shown that the annual incidence of non-A, non-B (NANB) hepatitis may be high in haemodialysis patients. To assess whether hepatitis C virus (HCV), the major causative agent of post-transfusion and community-acquired NANB hepatitis, has a role in the pathogenesis of liver disease in dialysed patients, we have studied the prevalence and significance of antibodies to HCV in a cohort of patients with end-stage renal disease on chronic haemodialysis treatment. Seventy-four (30%) had circulating antibodies to HCV. Statistically significant associations with the anti-HCV carrier status were duration of haemodialysis treatment, blood transfusions, and the finding of abnormally elevated ALT on retrospective analysis. In contrast, only one of 103 dialysis staff members showed transient positivity for anti-HCV, suggesting a low risk of professional exposure to HCV. These findings suggests that HCV infection is relatively frequent in haemodialysis patients and may be responsible for a significant proportion of liver disease in this clinical setting.

High Prevalence of Antibodies to Hepatitis C Virus in Hemodialysis Units Using a Second Generation Assay

“…Statistically significant associations with the anti-HCV carrier status were: duration of dialysis treat ment, blood transfusions and the retrospective finding of abnormally elevated ALT on at least I occasion (table 1). Although these associations were also found using the 1st generation assay [3], this study revealed that duration of dialysis was an independent risk factor of acquiring HCV infection, irrespective of blood transfusions (table 1). Thirty-seven anti-HCV-positive patients were also tested by 2nd generation recombinant immunoblot assay (RI BA).…”

“…Previous studies reported variable prevalences of expo sure to hepatitis C virus (HCV) in hemodialysis patients using a 1st generation assay that detects antibodies to a nonstructural protein, clOO-3 [1][2][3]. Circulating anti-cl00-3 is thought to be a sensitive indicator of viremia, as shown by the good correlation with HCV RN A [4], however, its role as a reliable marker of exposure to the virus remains question able.…”

Quantitative Assessment of HCV Load in Chronic Hemodialysis Patients: A Cross-Sectional Survey

“…Patients with end-stage renal disease (ESRD) undergoing chronic hemodialysis (HD) are a high-risk group for hepatitis C virus (HCV) infection with a high prevalence of anti-HCV antibodies, as reported by numerous investigators [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. Time on HD and blood transfusion requirement are the most important risk factors for acquiring HCV in this population.…”

Behavior of Antibody Profile against Hepatitis C Virus in Patients on Maintenance Hemodialysis

“…The observation that hemodialysis patients are a population at risk for HCV, while the staff members show none or poor serological evidence of C infection, suggests that HCV is not so readily transmitted as the hepatitis B virus [2,3], Indeed, the signifi cance of positive antibody test regarding potential infectivity is still controversial, especially in asymptomatic patients detected during screening procedures [4], However, the numerous reports of appreciable amounts of non-transfusion-related HCV seropositivities [1,3] and the increase in prevalence rates with the duration of dialysis [5] suggest the possibility of a cross-infection in the dialysis setting by 'unapparent' parenteral transmission of the virus [6] , To assess the prevalence, incidence and behavior of C infection, we performed a perspective study on a large number of patients dialysed at a single institution; treat ment modalities were therefore uniform. The study was also designed to detect whether the dialysis treatment may be considered a risk factor in contracting the infection.…”