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- Title
Patterns of Hepatitis C Viremia in Patients Receiving Hemodialysis.
- Authors
Umlauft, Florian; Gruenewald, Kurt; Weiss, Guenter; Kessler, Harald; Urbanek, Martina; Haun, Margot; Santner, Brigitte; Koenig, Paul; Keeffe, Emmet B.
- Abstract
Objectives: Chronic hepatitis C virus (HCV) infection is common in patients who receive hemodialysis (HD). The aim of this study was to determine the natural history of hepatitis C viremia and the clinical utility of quantitation and genotyping of HCV in this population of patients. Methods: Consecutive sera from two groups of HD patients who were HCV RNA positive, a group of 33 patients treated with interferon alfa (5 MU, three times a week for 4 months) and a group of 31 untreated patients, were analyzed by qualitative polymerase chain reaction, quantitative polymerase chain reaction, and a line probe assay for genotyping. Results: Serum HCV RNA was detected continuously in 20 of 31 untreated patients (65%), and 11 patients (35%) showed a fluctuating pattern of viremia with virus-free intervals of up to 4 wk. Twenty-five of 33 patients (76%) treated with interferon alfa became HCV RNA negative during therapy; eight of these 25 patients had a breakthrough, which was transient in seven patients and persistent in one. Of the remaining 24 end-of-treatment responders, 17 relapsed after completion of therapy, and seven (21%) had a sustained response with undetectable serum HCV RNA for 1 yr of follow-up. Initial serum HCV RNA levels in HD patients were generally low (median, 1 x 105 genome eq/ml). Sustained responders had significantly lower median levels of viremia (4 x 104 eq/ml) than relapsers and nonresponders (9 x 104 and 1.8 x 105 eq/ml, respectively). Genotyping revealed a predominance of genotype 1a (33%) and 1b (48%). Conclusions: This study documents that fluctuating hepatitis C viremia with periods of undetectable HCV RNA is common and that low viral load predicts a sustained response to interferon therapy in HD patients. Diagnosis of chronic hepatitis C and monitoring of interferon therapy in HD patients should include initial HCV RNA quantitation and repeated qualitative measurements of HCV RNA.
- Subjects
HEPATITIS C; HEPATITIS C virus; VIRUS diseases; HEMODIALYSIS; RNA
- Publication
American Journal of Gastroenterology (Springer Nature), 1997, Vol 92, Issue 1, p73
- ISSN
0002-9270
- Publication type
Article