Diagnosis of hepatitis C virus among hemodialysispatients—which is the ideal method?
Abstract
Background: Globally, it was estimated that hemodialysis (HD) was required in 3.9 million persons with kidney failure in 2017. The global prevalence of Hepatitis C virus (HCV) in the general population is approximated at 0.7% worldwide, and it varies from 1% to 85% in different countries among patients undergoing hemodialysis (HD). This study highlights the diagnostic efficacy of Immunochromatography test (ICT), fourth generation Enzyme-linked immunosorbent assay (ELISA) which determines anti-HCV antibodies and HCV core antigen, Real-time polymerase chain reaction (RT-PCR) for diagnosis of HCV infection in chronic HD patients and also assesses the impact of other factors including age, sex, length of dialysis, number of blood transfusions, and serum transaminases levels. Methods: Seventy-five patients diagnosed with end-stage renal disease (ESRD), who had been receiving HD for more than six months, were included. Blood samples were collected and subsequently analyzed for the presence of anti-HCV antibodies using an ICT, a fourth-generation ELISA, and RT-PCR. Results: Of the 75 samples tested, ICT, fourth-generation ELISA and RT-PCR were positive in eight (11%), 12 (16%), and 22 (29%) respectively. Conclusions: Solely screening for HCV antibodies is often not sufficient to exclude HCV infection in HD patients. Furthermore, HD patients do not always have detectable HCV RNA. Hence, close monitoring and stringent infection control practices are imperative to mitigate the transmission of HCV.
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References
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