RESUMEN
Hemodialysis patients are at high risk of developing HCV infection. Reports from various countries have shown a prevalence of 12-29% among this group. The present study aimed at assessing the utility of HCV antibodies and HCV-RNA detection in the diagnosis of HCV in Lebanese hemodialysis patients. One hundred and eight hemodialysis patients from various hospitals in Lebanon were assayed for the presence of anti-HCV antibodies by ELISA and LIA, and for the presence of HCV-RNA by RT-PCR of the 5' Non-coding region (5' NCR). Specificity of the amplicons was confirmed by Southern hybridization. Seventeen out of 108 patients were reactive in ELISA and positive in the Line Immunoassay (LIA). Eleven out of the 17 were positive by RT-PCR. Three out of 29 patients nonreactive in ELISA were positive by RT-PCR. Our results indicate that hemodialysis patients in this study may be grouped into 4 categories. These include (1) patients with viremia and no immune response, (2) patients with no viremia and with an immune response, (3) patients with both viremia and immune response and (4) patients with no viremia and no immune response. The first 3 categories may reflect the different phases of HCV infection and imply that detection of both anti-HCV antibodies and HCV-RNA are needed for the establishment of adequate diagnosis. In addition, data collected from patients implicated in this study show that infection by HCV may be dialysis machine-related, rather than transfusion-related. However, cross-contamination unrelated to machines may also occurs.
Asunto(s)
Hepacivirus/genética , Anticuerpos contra la Hepatitis C/análisis , ARN Viral/análisis , Diálisis Renal , Southern Blotting , Infección Hospitalaria/virología , Ensayo de Inmunoadsorción Enzimática , Hepacivirus/inmunología , Hepatitis C/diagnóstico , Hepatitis C/etiología , Hepatitis C/inmunología , Humanos , Inmunoensayo , Líbano , Hibridación de Ácido Nucleico , Reacción en Cadena de la Polimerasa , Prevalencia , ARN Viral/genética , Diálisis Renal/efectos adversos , Diálisis Renal/instrumentación , Factores de Riesgo , Factores de Tiempo , Transcripción Genética , Reacción a la Transfusión , Viremia/diagnósticoRESUMEN
We have genotyped the 5' noncoding region of hepatitis C virus in Lebanese hemodialysis patients by reverse transcription-PCR and restriction fragment length polymorphism analysis. Of 50 patients, 15 had the expected 268-bp amplicon by reverse transcription-PCR. Specificity of the amplicons was confirmed by Southern hybridization. Restriction analysis of the amplicons showed the pattern for genotype 4 (common in the Middle East).