Investigation of occult hepatitis c in dialysis patients

8. SUMMARY INVESTIGATION OF OCCULT HEPATITIS C IN DIALYSIS PATIENTS Occult Hepatitis C (OHC) virus infection (i.e., detectable HCV-RNA in the liver or peripheral blood mononuclear cells) in the absence of both serum HCV-RNA and anti-HCV antibodies has not been investigated in hemodialysis patients. This study aimed to evaluate the use of combining non-invasive assays to diagnose occult HCV. Sixty end stage renal disease patients, over 18 years old, receiving hemodialysis treatment were enrolled in this study. Participants' demograraphic data, type of vascular access in hemodialysis patients, duration of hemodialysis were all evaluated. Serum samples were tested for liver function tests and serological markers for hepatitis with EIA (Vitros). HCV RNA was extracted from the serum samples and PBMCs by using real-time PCR (Taqman 48, Roche). Occult HCV infection was described in patients with or without high liver function tests of unknown etiology and it is characterized by the presence of HCV RNA in the PBMCs despite negative results for anti-HCV and for serum HCV RNA as tested by conventional assays. The mean age of the patients was 62.75±12.36 years and 60% were male and the average duration of dialysis was 8.41±3.99 (1-19) years. Plasma HCV RNA and PBMCs RNA tests were not found positive in all anti-HCV negative and high ALT hemodialysis patients. Silent progression of HCV infection may cause progression of the disease and could be potential risk for the transmission of the virus. Detection of HCV RNA status in PBMCs of the patients, is non-invasive method that will help to determine occult infection. Key Words: Dialysis, peripheral blood mononuclear cells, Occult HCV