Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1996 Jul;34(7):1633–1636. doi: 10.1128/jcm.34.7.1633-1636.1996

High incidence of hepatitis C virus infection in hemodialysis patients in units with high prevalence.

F H Pujol 1, J G Ponce 1, M G Lema 1, F Capriles 1, M Devesa 1, F Sirit 1, M Salazar 1, G Vásquez 1, F Monsalve 1, L Blitz-Dorfman 1
PMCID: PMC229084  PMID: 8784559

Abstract

The prevalence of hepatitis C virus (HCV) infection was evaluated in 227 hemodialysis patients from four units in Caracas, Venezuela, by using different second- and third-generation enzyme immunoassays (EIAs) and immunoblot assays. HCV antibodies were detected in 162 patients (71%) by the recombinant-based second-generation assays (Abbott and Ortho) and in 161 patients by the synthetic peptide-based EIA (UBI). Of the 162 HCV antibody-positive serum samples, 161 were confirmed to be positive by RIBA 3. HCV RNA was detected in 49 of 68 (72%) of the seropositive patients and in 5 of 21 (24%) of the seronegative ones. HCV RNA was not always correlated with an increase in alanine aminotransferase (ALT) levels. Among 20 patients positive for HCV RNA and for HCV antibodies (without any hepatitis B virus [HBV] marker), only 10 had elevated ALT levels. The possible interference of HBV for HCV replication was evaluated. No significant difference was found between the presence of HCV RNA and the presence of any HBV serological markers. The possible routes of transmission of HCV in hemodialysis patients are multiple, and some of them are still controversial. Of the HCV-positive patients, 30% received a blood transfusion, significantly more than the 15% found for the HCV-negative group. However, blood transfusions alone could not account for the high incidence observed in this group of patients (38% from 1994 to 1995). In conclusion, about one-quarter of the apparently non-HCV-infected patients were probably seroconverting, ALT may not be a useful indicator of HCV infection in hemodialysis patients, and nosocomial transmission of HCV may play a role in the spread of HCV in this group.

Full Text

The Full Text of this article is available as a PDF (194.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alberti A., Pontisso P., Chemello L., Fattovich G., Benvegnù L., Belussi F., De Mitri M. S. The interaction between hepatitis B virus and hepatitis C virus in acute and chronic liver disease. J Hepatol. 1995;22(1 Suppl):38–41. [PubMed] [Google Scholar]
  2. Allander T., Medin C., Jacobson S. H., Grillner L., Persson M. A. Hepatitis C transmission in a hemodialysis unit: molecular evidence for spread of virus among patients not sharing equipment. J Med Virol. 1994 Aug;43(4):415–419. doi: 10.1002/jmv.1890430417. [DOI] [PubMed] [Google Scholar]
  3. Bukh J., Wantzin P., Krogsgaard K., Knudsen F., Purcell R. H., Miller R. H. High prevalence of hepatitis C virus (HCV) RNA in dialysis patients: failure of commercially available antibody tests to identify a significant number of patients with HCV infection. Copenhagen Dialysis HCV Study Group. J Infect Dis. 1993 Dec;168(6):1343–1348. doi: 10.1093/infdis/168.6.1343. [DOI] [PubMed] [Google Scholar]
  4. Caramelo C., Navas S., Alberola M. L., Bermejillo T., Reyero A., Carreño V. Evidence against transmission of hepatitis C virus through hemodialysis ultrafiltrate and peritoneal fluid. Nephron. 1994;66(4):470–473. doi: 10.1159/000187867. [DOI] [PubMed] [Google Scholar]
  5. Chiaramonte S., Tagger A., Ribero M. L., Grossi A., Milan M., La Greca G. Prevention of viral hepatitis in dialysis units: isolation and technical management of dialysis. Nephron. 1992;61(3):287–289. doi: 10.1159/000186907. [DOI] [PubMed] [Google Scholar]
  6. Dentico P., Volpe A., Buongiorno R., Carlone A., Carbone M., Manno M. Hepatitis C virus in hemodialysis patients. Nephron. 1992;61(3):307–308. doi: 10.1159/000186915. [DOI] [PubMed] [Google Scholar]
  7. Dienstag J. L., Alter H. J. Non-A, non-B hepatitis: evolving epidemiologic and clinical perspective. Semin Liver Dis. 1986 Feb;6(1):67–81. doi: 10.1055/s-2008-1040795. [DOI] [PubMed] [Google Scholar]
  8. Druwé P. M., Michielsen P. P., Ramon A. M., De Broe M. E. Hepatitis C and nephrology. Nephrol Dial Transplant. 1994;9(3):230–237. [PubMed] [Google Scholar]
  9. Goldblum S. E., Reed W. P. Host defenses and immunologic alterations associated with chronic hemodialysis. Ann Intern Med. 1980 Oct;93(4):597–613. doi: 10.7326/0003-4819-93-4-597. [DOI] [PubMed] [Google Scholar]
  10. Gubertini G., Scorza D., Beccari M., Buccianti G., Costantino A., Spotti D., Graziani G. Prevalence of hepatitis C virus antibodies in hemodialysis patients in the area of Milan. Nephron. 1992;61(3):271–272. doi: 10.1159/000186902. [DOI] [PubMed] [Google Scholar]
  11. Huang C. S., Ho M. S., Yang C. S., Lee C. L., Tan C. A. Hepatitis C markers in hemodialysis patients. J Clin Microbiol. 1993 Jul;31(7):1764–1769. doi: 10.1128/jcm.31.7.1764-1769.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Irie Y., Hayashi H., Yokozeki K., Kashima T., Okuda K. Hepatitis C infection unrelated to blood transfusion in hemodialysis patients. J Hepatol. 1994 Apr;20(4):557–559. doi: 10.1016/s0168-8278(05)80506-9. [DOI] [PubMed] [Google Scholar]
  13. Johnson R. J., Willson R., Yamabe H., Couser W., Alpers C. E., Wener M. H., Davis C., Gretch D. R. Renal manifestations of hepatitis C virus infection. Kidney Int. 1994 Nov;46(5):1255–1263. doi: 10.1038/ki.1994.393. [DOI] [PubMed] [Google Scholar]
  14. Liaw Y. F. Role of hepatitis C virus in dual and triple hepatitis virus infection. Hepatology. 1995 Oct;22(4 Pt 1):1101–1108. doi: 10.1016/0270-9139(95)90615-0. [DOI] [PubMed] [Google Scholar]
  15. Mioli V. A., Balestra E., Bibiano L., Carletti P., Della Bella S., Fanciulli E., Gaffi G., Marinelli R., Perilli R., Ricciatti A. M. Epidemiology of viral hepatitis in dialysis centers: a national survey. Nephron. 1992;61(3):278–283. doi: 10.1159/000186905. [DOI] [PubMed] [Google Scholar]
  16. Muller G. Y., Zabaleta M. E., Arminio A., Colmenares C. J., Capriles F. I., Bianco N. E., Machado I. V. Risk factors for dialysis-associated hepatitis C in Venezuela. Kidney Int. 1992 Apr;41(4):1055–1058. doi: 10.1038/ki.1992.160. [DOI] [PubMed] [Google Scholar]
  17. Nordenfelt E., Löfgren B., Widell A., Hansson B. G., Zhang Y. Y., Hagstam K. E., Kurkus J. Hepatitis C virus infection in hemodialysis patients in southern Sweden: epidemiological, clinical, and diagnostic aspects. J Med Virol. 1993 Aug;40(4):266–270. doi: 10.1002/jmv.1890400403. [DOI] [PubMed] [Google Scholar]
  18. Ohkawa K., Hayashi N., Yuki N., Masuzawa M., Kato M., Yamamoto K., Hosotsubo H., Deguchi M., Katayama K., Kasahara A. Long-term follow-up of hepatitis B virus and hepatitis C virus replicative levels in chronic hepatitis patients coinfected with both viruses. J Med Virol. 1995 Jul;46(3):258–264. doi: 10.1002/jmv.1890460316. [DOI] [PubMed] [Google Scholar]
  19. Okuda K., Hayashi H., Kobayashi S., Irie Y. Mode of hepatitis C infection not associated with blood transfusion among chronic hemodialysis patients. J Hepatol. 1995 Jul;23(1):28–31. doi: 10.1016/0168-8278(95)80307-6. [DOI] [PubMed] [Google Scholar]
  20. Pol S., Romeo R., Zins B., Driss F., Lebkiri B., Carnot F., Berthelot P., Bréchot C. Hepatitis C virus RNA in anti-HCV positive hemodialyzed patients: significance and therapeutic implications. Kidney Int. 1993 Nov;44(5):1097–1100. doi: 10.1038/ki.1993.354. [DOI] [PubMed] [Google Scholar]
  21. Pru C. E., Cuervo C., Ardila M., Teran M. Hepatitis C transmission through dialysis machines. ASAIO J. 1994 Jul-Sep;40(3):M889–M891. doi: 10.1097/00002480-199407000-00124. [DOI] [PubMed] [Google Scholar]
  22. Sakamoto N., Enomoto N., Marumo F., Sato C. Prevalence of hepatitis C virus infection among long-term hemodialysis patients: detection of hepatitis C virus RNA in plasma. J Med Virol. 1993 Jan;39(1):11–15. doi: 10.1002/jmv.1890390104. [DOI] [PubMed] [Google Scholar]
  23. Sampietro M., Badalamenti S., Salvadori S., Corbetta N., Graziani G., Como G., Fiorelli G., Ponticelli C. High prevalence of a rare hepatitis C virus in patients treated in the same hemodialysis unit: evidence for nosocomial transmission of HCV. Kidney Int. 1995 Mar;47(3):911–917. doi: 10.1038/ki.1995.136. [DOI] [PubMed] [Google Scholar]
  24. Simon N., Couroucé A. M., Lemarrec N., Trépo C., Ducamp S. A twelve year natural history of hepatitis C virus infection in hemodialyzed patients. Kidney Int. 1994 Aug;46(2):504–511. doi: 10.1038/ki.1994.301. [DOI] [PubMed] [Google Scholar]
  25. Stuyver L., Claeys H., Wyseur A., Van Arnhem W., De Beenhouwer H., Uytendaele S., Beckers J., Matthijs D., Leroux-Roels G., Maertens G. Hepatitis C virus in a hemodialysis unit: molecular evidence for nosocomial transmission. Kidney Int. 1996 Mar;49(3):889–895. doi: 10.1038/ki.1996.122. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES