Peritoneal Dialysis International, Vol. 12, pp. 28-30 0896-8608/92 $3.00 + .00
Printed in Canada. All rights reserved Copyright © 1992 International Society for Peritoneal Dialysis
Prevalence of Hepatitis C Antibodies (HCV)
in a Dialysis Population at One Center
Rafael Selgas, Rosa Martinez-Zapico, M. Auxiliadora Bajo, Jose Ramon Romero, Jesus Munoz, Carmen Rinon,
Blanca Miranda, and Jose Luis Miguel
Hospital La Paz, Madrid, Spain
Hepatitis C (HC) has been recently diagnosed by de-
termination of specific antibodies that represent the former so-
called non-A, non-B hepatitis.
We studied the prevalence of plasma HCV antibodies among
61 unselected patients on hemodialysis (HD) and 43 on
continuous ambulatory peritoneal dialysis (CAPD). Plasma C-
antibodies were determined through the ELISA test system.
Transfusion policy was the same in both
groups.
The prevalence of hepatitis C virus antibodies was
significantly higher in hemodialysis patients than among those on
CAPD. Time on dialysis, previous blood trans fusions, and renal
transplantation seem to increase the prevalence of C hepatitis
antibodies among hemodialysis patients. The effect of these
parameters on CAPD was smaller. Understanding the reasons for
these differences may help prevent this disease among dialysis
patients.
KEY WORDS: Hepatitis C; non-A, non-B hepatitis; dialysis-
associated hepatitis.
H
epatitis C has been recently diagnosed by de-
termination of specific antibodies that represent
the former so-called non-A, non-B hepatitis (1-5). Non-A,
non-B hepatitis remains the most important complication of
blood transfusion nowadays, and may induce chronic
hepatitis (6,7). The relationship of hepatitis to dialysis has
long been recognized, but the absence of a serologic
marker has precluded a better definition of non-A, non-B
hepatitis among these patients (8). Its prevalence among
dialysis patients, who often receive blood transfusions, re-
mains to be established (4). Patients on continuous
ambulatory peritoneal dialysis (CAPD) have fewer
transfusion requirements than those on hemodialy sis (HD)
(9). If blood transfusions are the main risk factor for
hepatitis C, hemodialysis patients should be at a higher risk
for developing this disease than those on CAPD.
Correspondence to: Rafael Selgas, Servicio de Nefrolo
gia, Hospital La Paz, Castellana 261, Madrid, Spain 28046
Received January 10, 1991; accepted Apri122, 1991.
The aim of this study was to explore the prevalence of
plasma HCV antibodies among our patients on
hemodialysis and CAPD, both programs having similar
transfusion policies.
PATIENTS AND METHODS
This cross-sectional study was performed among 61
unselected patients on chronic hemodialysis and 43 patients
on CAPD. Intravenous drug abusers were excluded from the
study. The mean times on dialysis were 78±63 and
32±27 months respectively. Twenty-nine patients
on CAPD and 22 on hemodialysis were treated for less than
3 years. Twentyseven patients on HD and 8 on CAPD were
treated for more than 5 years. Only 5 CAPD patients had
been on HD for periods ranging from 3-6 years prior to
starting CAPD. Table 1 shows the blood transfusion
requirements and previous renal transplantation status
among these patients. Hemodialysis patients with positive
hepatitis C test were treated in i solation with their own
machines.
Treatment of anemia with erythropoietin was introduced
in our unit 2 years ago and has diminished transfusion
requirements. No specific program of pretransplant blood
transfusions was practised in these patients.
Laboratory tests: Hepatitis C antibodies were determined
by an ELISA test system (Ortho HCV Antibody) performed
in duplicate for each patient. Hepatitis B serology was
performed by a commercial kit (Enzygnost, Behring).
Alanine aminotransferase plasma levels were measured
by autoanalyzer. Twenty-four patients on HD and 3 on
CAPD showed chronic and moderate elevation (2 to 3 fold)
of aminotransferase levels and were classified as having
chronic hepatitis, confirmed in 6 by liver biopsy. Two of the
3 CAPD patients from the biopsied group showed drug and
ethanol-related hepatitis, and the third patient showed
chronic active hepatitis Type B, according to the presence
of serologic markers. None of the HD patients included in
the biochemically hepatitis -diagnosed group had a clear
etiologic factor; patients were diagnosed as having
persistent or chronic forms