Hepatitis C Viral Infection in Hemodialysis Patients: Clinical and Molecular Studies

血液透析病患C型肝炎病毒感染之臨床及分子研究

吳義勇(Yee-Yung NG) ； 黃信彰(Shinn-Jang Hwang) ； 吳肖琪(Shiao-Chi Wu) ； 盧瑞華(Rei-Hwa Lu) ； 候君正(Chun-Chen Hou) ； 楊五常(Wu-Chang Yang) ； 李壽東(Shou-Dong Lee)

《Acta Nephrologica》 14卷1期 (2000/01) Pp. 12-16

摘要

Hepatitis C viral (HCV) infection has become an important cause for liver disease in hemodialysis patients worldwide. We compared the serum alanine aminotransferase (ALT) in 126hemodialysis (HD) patients (mean age 57.3 ± 15.6 years;68male, 58 female) with negative serum antibody to HCV (anti-HCV) and hepatitis B surface antigen patients to 70 HD patients (mean age 53.9 ± 14.6 years;42 male, 28 female) with positive anti-HCV and negative hepatitis B surface antigen. Quantitation of serum HCV RNA was measured by a quantitative bNDA singal amplification assay and RT-nested PCR. The patients with positive anti-HCV had higher mean ALT values than those without (20.5 ± 11.7 IU/L vs 13.7 ± 9.21 IU/L，P＜0.001). 30 (42.8%) and 48 (68.5%) of 70 patients with positive serum anti-HCV and negative hepatitis B surface antigen were positive for serum HCV-RNA by branched DNA signal amplification (bDNA) assay and reverse transcription-nested polymerase chain reaction (RT-nested PCR), respectively. The mean serum ALT levels were significantly higher in patients with positive serum HCV RNA than negative serum HCV RNA (22.4 ± 12.7 IU/L vs 16.5 ± 7.8 IU/L，P＜0.05). If the cutoff point of upper normal level of serum ALT is set at 16 IU/L, there was a significant more patients with elevated ALT level in patients with positive HCV RNA than those with negative serum HCV RNA (77.1% vs 45.5%，P＜0.01). The dialysis patients with anti-HCV (+) and serum level of ALT greater than 16 IU/L have a higher risk of positive serum HCV RNA (odds ratio: 4.3, 95% CI:1.4~13.1, p＜0.05).
In conclusion, 68.5% HD patients with positive anti-HCV had positive serum HCV RNA. Patients with positive anti-HCV and serum ALT greater than 16 IU/L have higher risk of HCV viremia.

並列摘要

Hepatitis C viral (HCV) infection has become an important cause for liver disease in hemodialysis patients worldwide. We compared the serum alanine aminotransferase (ALT) in 126hemodialysis (HD) patients (mean age 57.3 ± 15.6 years;68male, 58 female) with negative serum antibody to HCV (anti-HCV) and hepatitis B surface antigen patients to 70 HD patients (mean age 53.9 ± 14.6 years;42 male, 28 female) with positive anti-HCV and negative hepatitis B surface antigen. Quantitation of serum HCV RNA was measured by a quantitative bNDA singal amplification assay and RT-nested PCR. The patients with positive anti-HCV had higher mean ALT values than those without (20.5 ± 11.7 IU/L vs 13.7 ± 9.21 IU/L，P＜0.001). 30 (42.8%) and 48 (68.5%) of 70 patients with positive serum anti-HCV and negative hepatitis B surface antigen were positive for serum HCV-RNA by branched DNA signal amplification (bDNA) assay and reverse transcription-nested polymerase chain reaction (RT-nested PCR), respectively. The mean serum ALT levels were significantly higher in patients with positive serum HCV RNA than negative serum HCV RNA (22.4 ± 12.7 IU/L vs 16.5 ± 7.8 IU/L，P＜0.05). If the cutoff point of upper normal level of serum ALT is set at 16 IU/L, there was a significant more patients with elevated ALT level in patients with positive HCV RNA than those with negative serum HCV RNA (77.1% vs 45.5%，P＜0.01). The dialysis patients with anti-HCV (+) and serum level of ALT greater than 16 IU/L have a higher risk of positive serum HCV RNA (odds ratio: 4.3, 95% CI:1.4~13.1, p＜0.05).
In conclusion, 68.5% HD patients with positive anti-HCV had positive serum HCV RNA. Patients with positive anti-HCV and serum ALT greater than 16 IU/L have higher risk of HCV viremia.

並列關鍵字

hepatitis C ； hemodialysis ； bDNA assay ； RT-nested PCR