Quantitation of Hepatitis C Viral RNA in Sera of Hemodialysis Patients: Gender-Related Differences in Viral Load

D. B. DuBois, D. Gretch, C. Dela Rosa, W. Lee, J. Fine, C. R. Blagg, L. Corey

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Hepatitis C virus (HCV) infection is common in hemodialysis patients, as determined by antibody assays and qualitative polymerase chain reaction (PCR) analysis of serum HCV RNA. To further characterize HCV infection in this population, we measured the viral load in infected hemodialysis patients by a quantitative, competitive PCR assay (QC-PCR) for HCV RNA. Hepatitis C virus RNA levels were correlated with serologic, biochemical, and demographic features of a cohort of hemodialysis patients. Sera from 208 hemodialysis patients were screened for HCV RNA (5′ conserved region) by reverse transcriptase PCR (RT-PCR) and HCV-specific antibody. Forty-four patients were antibody positive (21%); among these patients, 34 (77%) were HCV RNA positive. No viremic, seronegative patients were identified. Hepatitis C virus RNA levels quantitated by QC-PCR ranged from 3 × 105 to 108 molecules of HCV RNA/mL. Male patients had significantly higher mean and median HCV RNA levels (107 molecules/mL) compared with female patients (3.6 × 106 moleculeslmL and 3 × 106 molecules/mL, respectfully; P = 0.02). No other demographic or clinical feature of this cohort correlated with HCV RNA levels. Intravenous drug abuse was the most frequently identified risk factor (29% of seropositive patients) for infection with HCV in this population. No association between HCV RNA levels and hepatic enzyme levels (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase) was apparent. Hepatitis C virus infection is highly prevalent in our hemodialysis population, and hemodialysis patients, particularly males, have high levels of HCV in serum. Furthermore, hepatic enzyme markers are very poor indicators of ongoing HCV infection. Accurate characterization of the virologic status of HCV-infected patients requires both serologic testing and HCV RNA detection.

Original languageEnglish (US)
Pages (from-to)795-801
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume24
Issue number5
DOIs
StatePublished - Jan 1 1994

Keywords

  • Hemodialysis
  • RNA
  • hepatitis C virus
  • polymerase chain reaction
  • transaminase

ASJC Scopus subject areas

  • Nephrology

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