Abstract
The prevalences of two kinds of anti-hepatitis C virus (HCV) antibodies and HCV RNA were assessed in 30 patients undergoing hemodialysis. C100-3 antibody (HCV first generation antibody) was measured using an ELISA test (Ortho Diagnostics). A combination of antibodies against a core region and non-structural regions of the HCV genome (HCV second generation antibody) was measured by means of an EIA kit (Dainabot Corp.). HCV RNA (5'-noncoding region) was detected by a nested polymerase chain reaction (PCR).
C100-3 antibodies were positive in 10 (33%), second generation antibodies were positive in 18 (60%) and HCV RNAs were positive in 16 (53%) patients. Among 14 HCV RNA-negative patients, only three cases were anti-HCV-positive. The prevalence of each assay increased in accordance with the amount of transfusions, grade of liver injury and duration of hemodialysis. In all of the HCV RNA-positive cases, the cut-off indices of the second generation antibody were more than 90. Half of these cases were anti-C100-3-negative, and most of these patients maintained a normal transaminase level despite episodes of liver injury in the past. This indicated the presence of asymptomatic HCV carriers undergoing hemodialysis who had been missed by the screening using C100-3 antibody.
The prevalence of C100-3 antibody in the entire patient population of our hemodialysis unit was lower (13/57, 23%) than that determined in this study. Therefore, approximately one third of our hemodialysis patients were estimated to be HCV carriers. Based on the result confirming that second generation antibody and HCV RNA are closely related, the second generation antibody is assumed to be a useful assay for the screening of HCV carriers undergoing hemodialysis.
