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  • 1 Semmelweis University Transplantation and Surgical Clinic, Budapest, Hungary
  • 2 EGIS Pharmacenticals LTD., Budapest, Hungary
  • 3 EUROCARE Dialysis Center, Békéscsaba, Hungary
  • 4 Transplantation and Surgical Clinic, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary
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Abstract

Patients on hemodialysis (HD) and renal transplant recipients (RT) have a high prevalence of HCV infection. The aim of our study was to determine the prevalence of HCV-RNA in the anti-HCV positive patients and to compare the biochemical parameters of PCR(+) and PCR(−) subgroups. Methods: The 525 sera were screened for anti-HCV. HCV-RNA was detected by polymerase chain reaction (PCR) and liver enzymes [SGOT, SGPT, GGT, α-glutathione S-transferase (GST)] were measured. Results: Active viraemia was found only in 187 of 289 (65%) seropositive HD patients in contrast to 53 of 53 (100%) of seropositive RT patients. Significantly increased (p<0.05) GST values (9.9 μg/l) were found in the PCR(+) subgroups compared to GST levels (2.7 μg/l) of the PCR(−) subgroups. Elevated GST concentration was found in 80% (208/251) of PCR(+) patients. The measured enzymes were not elevated in HCV infected patients. Six percent of HD and 11% of RT patients were screened before seroconversion. Diagnostic sensitivity (80%) and specificity (79%) of GST were calculated as good for early liver damage caused by HCV. In contrast, the sensitivity of the measurement of other liver enzymes were very weak (SGOT: 8%; SGPT: 10%; GGT: 42%). Conclusion: The significantly higher viraemia of the RT subgroup could be related to the immunosuppressive therapy. Increased GST level may be a useful indicator of tissue damage during HCV infection. If HCV infection is suspected, PCR and GST measurement should be performed, even if anti-HCV result is negative.

  • 1. C. Caramelo A. Ortis B. Aguilera 1993 Liver disease patterns in hemodialysis patients with antibodies to hepatitis C virus Am J Kidney Dis 22 822 828.

    • Search Google Scholar
    • Export Citation
  • 2. C. Caramelo J. Bartolomé M. Albalate 1996 Undiagnosed hepatitis C virus infection in hemodialysis patients: Value of HCV-RNA and liver enzyme levels Kidney Int 50 2027 2031.

    • Search Google Scholar
    • Export Citation
  • 3. P. Kes J. Slavicek 2009 Hepatitis C virus and chronic progressive kidney disease [Croatian] Acta Med Croatica 63 5 431 436.

  • 4. P. Dentico R. Buongiorno A. Volpe 1992 Prevalence and incidence of hepatitis C virus (HCV) in hemodialysis patients: Study of risk factors Clin Nephrol 38 49 52.

    • Search Google Scholar
    • Export Citation
  • 5. M. Boran S. Cetin 1999 The role of alpha Glutathione S-Transferase in the monitoring of hemodialysis patients with hepatitis C virus infection undergoing high-dose interferon-alpha-2b therapy Nephron 82 22 26.

    • Search Google Scholar
    • Export Citation
  • 6. G.I. Muller M.E. Zabaleta A. Armenio 1992 Risk factors for dialysis-associated hepatitis C in Venezuela Kidney Int 41 1055 1058.

  • 7. R. Seelig M. Renz C. Bottner H.P. Seelig 1994 Hepatitis C virus infection in dialysis units: Prevalence of HCV-RNA and antibodies to HCV Ann Med 26 45.

    • Search Google Scholar
    • Export Citation
  • 8. M. Valencia Yábar J. Cieza Zevallos 2009 Factors associated with Hepatitis C infection in patients with chronic hemodialysis Rev Gastroenterol Peru 29 1 11 16.

    • Search Google Scholar
    • Export Citation
  • 9. M.E. Brunson Y.N. Lau G.L. Davis 1993 Non-A non-B hepatitis and elevated serum aminotransferases in renal transplant patients. Correlation with hepatitis C infection Transplantation 56 1364 1367.

    • Search Google Scholar
    • Export Citation
  • 10. L. Stuyver H. Claeys A. Wyseur 1996 Hepatitis C virus in hemodialysis units: Molecular evidence for nosocomial transmision Transplantation 49 889.

    • Search Google Scholar
    • Export Citation
  • 11. D. Roth J.A. Fernandez S. Babischkin 1992 Detection of hepatitis C infection among cadaver organ donors: evidence for low transmission of disease Ann Int Med 117 470.

    • Search Google Scholar
    • Export Citation
  • 12. F. Fabrizi P. Messa P. Martin 2009 Current status of renal transplantation from HCV-positive donors Int J Artif Organs 32 5 251 261.

    • Search Google Scholar
    • Export Citation
  • 13. P. Chauveau A.M. Courouce N. Lemarec 1993 Antibodies to hepatitis C virus by second generation test in hemodialysed patients Kidney Int 43 Suppl4 S149 S152.

    • Search Google Scholar
    • Export Citation
  • 14. G. Kuo Q.L. Choo H.J. Alter 1989 An assay for circulating antibodies to a major etiologic virus of human non-A non-B hepatitis Science 244 362.

    • Search Google Scholar
    • Export Citation
  • 15. A. Di Maggio R. Annicchiarico M. De Siati 1992 Confirmation of high prevalence of hepatitis C antibodies in hemodialysis patients by second generation immunoblot assay Nephron 61 347.

    • Search Google Scholar
    • Export Citation
  • 16. T.M. Chan A.S.F. Lok I.K.P. Cheng 1991 Hepatitis C in renal transplant recipients Transplantation 52 810.

  • 17. C.C. Huang Y.F. Liaw M.K. Lai 1992 The clinical outcome of hepatitis C virus antibody-positive renal allograft recipients Transplantation 53 763.

    • Search Google Scholar
    • Export Citation
  • 18. E. Ponz J.M. Campistol M. Bruguera 1991 Hepatitis C infection among kidney transplant recipients Kidney Int 40 748.

  • 19. K. Krawczynsky M. Beach D.W. Bradley 1992 Immunosuppression and pathogenic studies of acute hepatitis C virus infection Hepatology 16 2 131A.

    • Search Google Scholar
    • Export Citation
  • 20. M. Schroter H.H. Feucht P. Schafer 1997 High percentage of seronegative HCV infections in hemodialysis patients: the need for PCR Intervirology 40 277.

    • Search Google Scholar
    • Export Citation
  • 21. M. Kuhns M. Medina A. Mc Namara 1994 Detection of hepatitis C virus RNA in hemodialysis patients J Am Soc Nephrol 4 1491 1497.

  • 22. A. Meshari M. Ahdal O. Alfurayh 1995 New insights into hepatitis C virus infection of hemodialysis patients: The implications Am J Kidney Dis 25 572 578.

    • Search Google Scholar
    • Export Citation
  • 23. T. Mitsui K. Ivano K. Masudo 1992 Hepatits C virus infection in medical personnel after needlestick accident Hepatology 16 1109 1114.

    • Search Google Scholar
    • Export Citation
  • 24. Y. Zer I. Karaoğlan H. Ciçek I.D. Karağoz M. Sağlam 2009 Evaluation of the patients with low levels of anti-HCV positivity Mikrobiyol Bul. 43 1 133 139.

    • Search Google Scholar
    • Export Citation
  • 25. M. Pouti A. Zonaro A. Ravagil 1992 Hepatitis C virus RNA and antibody response in the clinical course of acute hepatitis C virus infection Hepatology 16 877 881.

    • Search Google Scholar
    • Export Citation
  • 26. K.Y. Young R. Resnik T.W. Myers 1993 Detection of hepatitis C virus RNA by a combined reverse transcriptase-polymerase chain reaction assay J Clin Microbiol 31 882 886.

    • Search Google Scholar
    • Export Citation
  • 27. A. Maheshwari S. Ray P.J. Thuluvath 2008 Acute hepatitis C Lancet 26 3729635 321 332.

  • 28. A.M. Di Bisceglie Z.D. Goodman K.G. Ishak 1991 Long-term clinical and histopathological follow-up of chronic posttransfusion hepatitis Hepatology 14 969 974.

    • Search Google Scholar
    • Export Citation
  • 29. J.I. Esteban J.C. Lopez-Talavera J. Genesca 1991 High-rate of infectivity and liver disease in blood donors with antibodies to hepatitis C virus Ann Intern Med 115 443 449.

    • Search Google Scholar
    • Export Citation
  • 30. D.B. Mc Bill J. Rakela A.R. Zinsmeister 1990 A 21-year experience with major hemorrhage after percutaneous liver biopsy Gastroenterology 99 1396 1400.

    • Search Google Scholar
    • Export Citation
  • 31. K.S. Henley M.R. Lucey H.D. Appleman 1992 Biochemical and histological correlation in liver transplant: the first 180 days Hepatology 16 688.

    • Search Google Scholar
    • Export Citation
  • 32. A.K. Trull S.P. Facey G.W. Rees 1994 Serum α-Glutathione S-tranferase a sensitive marker of hepatocellular damage associated with acute liver allograft rejection Transplantation 58 1345 1351.

    • Search Google Scholar
    • Export Citation
  • 33. Alter MJ , Kuhnert WL, Finelli L: Guidelines for laboratory testing and result reporting of antibodies to HCV. Morbidity and mortality weekly report 52 (RR-3), 113 (2003).

    • Search Google Scholar
    • Export Citation
  • 34. A.H. Schuurs B.K. van Weemen 1980 Enzyme-immunoassay: A powerful analytical tool J Immunoassay 1 2 229 249.

  • 35. N. DiDomenico H. Link R. Knobel 1996 COBAS AMPLICOR: a fully automated RNA and DNA amplification and detection system for routine diagnostic PCR Clin Chem 42 1915 1923.

    • Search Google Scholar
    • Export Citation
  • 36. S. Zeuzeum B. Rüster W.K. Roth 1994 Clinical evaluation of a new polymerase chain reaction assay (AmplicorTM HCV) for detection of hepatitis C virus Gastroenterology 32 342 347.

    • Search Google Scholar
    • Export Citation
  • 37. Y. Chen L.D. Cooper G.D. Ehrlich 1996 Comparative analysis of three nucleic acid-based detection system for hepatitis C virus RNA in plasma from liver transplant recipients Molecular and Cellular Probes 10 331 336.

    • Search Google Scholar
    • Export Citation
  • 38. K. Matsuura Y. Tanaka I. Hasegawa T. Ohno H. Tokuda F. Kurbanov F. Sugauchi S. Nojiri T. Joh M. Mizokami 2009 Abbott RealTime hepatitis C virus (HCV) and Roche Cobas AmpliPrep/Cobas Taq-Man HCV assays for prediction of sustained virological response to pegylated interferon and ribavirin in chronic hepatitis C patients J Clin Microbiol 47 2 385 389.

    • Search Google Scholar
    • Export Citation
  • 39. Statistica for Windows. StatSoft, Inc. (1994).

  • 40. B.J.G. Pereira A.S. Levey 1997 Hepatitis C virus infection in dialysis and renal transplantation Kidney Int 51 981.

  • 41. J.M. Diego M. Roth 1998 Treatment of hepatitis C infection in patients with renal disease Curr Opin Nephrol Hypertens 7 557.

  • 42. B.J. Pereira S.N. Natov B.A. Bouthot 1998 Effect of hepatitis C infection and renal transplantation on survival in end stage renal disease Kidney Int 53 1374.

    • Search Google Scholar
    • Export Citation
  • 43. H.J. Alter J.W. Purcell J.C. Shih 1989 Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A non-B hepatitis N Eng J Med 321 1494 1500.

    • Search Google Scholar
    • Export Citation
  • 44. R.D. Soloway W.H.J. Summerskill A.H. Baggenstoss 1972 Clinical, biochemical and histological remission of severe chronic active liver disease: Controlled study of treatments and early prognosis Gastroenterology 63 820.

    • Search Google Scholar
    • Export Citation
  • 45. G.A. Mannes F. Stellard G. Paumgartner 1982 Increased serum bile acids in cirrhosis with normal transaminases Digestion 25 217.

  • 46. P.L. Wolf D. Williams N. Coplon 1972 Transaminase activity in serum of patients undergoing chronic hemodialysis Clin Chem 18 6 567 569.

    • Search Google Scholar
    • Export Citation
  • 47. B. Nemes A. Doros Holczbauer E. Sárváry P. Nagy G. Lengyel A. Kiss Z. Schaff 2009 Expression pattern of molecular chaperones after liver transplantation in hepatitis C positive recipients. Relation to serum HCV-RNA titers IMAS 1 1 35 40.

    • Search Google Scholar
    • Export Citation
  • 48. G.J. Beckett J.D. Hayes 1993 Glutathione S-transferases: Biomedical Applications Adv Clin Chem 30 281 380.

  • 49. D.R. Nelson 1995 Alpha Glutathione S-transferase as a marker of hepatocellular damage in chronic hepatitis C virus infection Am J Clin Pathol 104 193 198.

    • Search Google Scholar
    • Export Citation
  • 50. G.F. Helaly M.M. Mahmoud 2003 Diagnostic value of alpha-glutathione S-transferase as a sensitive marker of increased risk for hepatocellular damage in hepatitis C virus (HCV) infection: relation to HCV viraemia J Egypt Public Health Assoc. 78 3–4 209 223.

    • Search Google Scholar
    • Export Citation
  • 51. C. Hiley 1988 The human Glutathione S-transferases: Immunohistological studies of the developmental expression of alpha- and pi-class isoenzymes in liver Biochem J 284 255 259.

    • Search Google Scholar
    • Export Citation
  • 52. G.J. Becket J.D. Hayes 1987 Plasma Glutathione S-transferase measurements and liver disease in man J Clin Biochem Nutr 2 1.

  • 53. V. Calvaruso A. Craxì 2009 Implication of normal liver enzymes in liver disease J Viral Hepat 16 8 529 536.

  • 54. G.J. Becket G.R. Foster A.J. Hussey 1989 Plasma Glutathione S-transferase and F-protein are more sensitive than alanine aminotransferase as markers of paracetamol-induced liver damage Clin Chem 35 2186.

    • Search Google Scholar
    • Export Citation
  • 55. E. Sárváry A. Blázovics M. Varga B. Sulyok J. Járay M. Lakatos F. Perner 1998 Diagnostic value of glutathione-S-transferase Orv Hetil. 21 13925 1531 1537.

    • Search Google Scholar
    • Export Citation
  • 56. J.O. Smith R.K. Sterling 2009 Systematic review: non-invasive methods of fibrosis analysis in chronic hepatitis C Aliment Pharmacol Ther 15 306 557 576.

    • Search Google Scholar
    • Export Citation
  • 57. A. Davenport F. Myers 2009 How to protect yourself after body fluid exposure Nursing 39 5 22 28.

  • 58. C. Puoti L. Bellis R. Guarisco O. Dell' Unto L. Spilabotti O.M. Costanza 2009 HCV carriers with normal alanine aminotransferase levels: Healthy persons or severely ill patients? Dealing with an everyday clinical problem Eur J Intern Med 21 2 57 61.

    • Search Google Scholar
    • Export Citation
  • 59. M. Krajdem 1995 Molecular detection of hepatitis C virus: Impact of detection methodology on clinical and laboratory correlations Crot Rev Clin Lab Sci 32 1 41 46.

    • Search Google Scholar
    • Export Citation

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